Provides a data management platform for healthcare payers that consolidates and normalizes diverse data sources into interoperable, 360-degree patient records. This enables compliance with CMS mandates, improves risk adjustment accuracy, and reduces costs by delivering timely, usable data for clinical, operational, and reporting needs.
Funding
$100.8M raised to dateRaised to date based on public sources. This may differ from the amount the company actually raised and is based only on what is publicly available on the internet.
MFounders
Product
Problem
Healthcare payers struggle with fragmented data residing in disparate systems, hindering their ability to create a comprehensive view of members. This lack of interoperability leads to inefficiencies in risk adjustment, difficulties in complying with regulatory mandates like those from CMS, and increased costs due to delayed or inaccurate data insights.
Solution
Abacus Insights offers a data management platform designed specifically for healthcare payers, consolidating and normalizing data from various sources into a unified, interoperable longitudinal patient record (LPR). The platform cleans data, removes redundancies, and traces data lineage to ensure accuracy. By providing a complete and timely view of member data, Abacus Insights enables payers to improve risk adjustment accuracy, comply with CMS interoperability mandates, and reduce costs through better clinical, operational, and reporting insights. The platform's architecture supports a wide range of analytical and operational applications, systems, and formats, making data usable across various business needs.
Target Audience
The primary target audience includes healthcare payers, such as health plans and Accountable Care Organizations (ACOs), seeking to improve data usability, interoperability, and compliance with regulatory requirements.
Features
- Data consolidation and normalization from structured, unstructured, internal, and external sources
- Data cleaning to eliminate redundancies and errors, with data lineage tracking
- Timely data delivery and updates using legacy and modern interfaces and protocols
- Application and use-case agnostic design, compatible with various analytical and operational systems
- Contextual data analysis to identify relevant information and filter out extraneous data
- Flexible data extraction, bundling, and delivery in custom formats for specific use cases
- Support for risk adjustment, CMS interoperability, clinical data exchange, and HEDIS/STARs reporting
- Longitudinal Patient Record (LPR) creation for a 360-degree view of member data