Risk Adjustment, Cost-of-Care, CMS Interoperability, Clinical Data, and more key functions gain unprecedented control and agility in managing their own data

Boston, March 6, 2023— Abacus Insights, the leader in data usability for payers, has launched a new tool that is a game-changing advantage in health plans’ ability to drive improved performance to meet new standards for care, cost, and efficiency. The new tool, MyMetrics, breaks the logjam in getting usable data and metrics flowing to payers’ critical functions and business needs such as risk adjustment, cost-of-care, clinical data, and CMS interoperability so executives have unhindered access for decision-making and management.

Meet us at RISE National 2023 to discuss the MyMetrics tool and other ways to ensure usable data to improve risk adjustment performance and compliance. Schedule here.

MyMetrics also offers payers a major leap forward in data governance and control by establishing the first-ever standardized definitions of key data across the entire organization, enabling reliable comparisons and a consolidated view.

“Call it the democratization of data and a resolution of a major impediment to payers transforming their operations when data usability at a department level with common definitions is made available. This means executives can get aligned in driving key priorities in quality, equity, member and provider experience, and affordability – all of those critical aims,” said Minal Patel, MD, founder and CEO of Abacus Insights.

MyMetrics are offered in a table accessed through any reporting tool customized for each executive, allowing for review by the line of business, product, geography, attributed provider, and disease cohort. The metrics and calculations are automated and validated with no coding required. They also include the underlying data sets.

Abacus Insights offers more than 100 metrics specific to functions and broader health plan goals. For example, for risk adjustment, the company provides risk scores, provider attribution, suspected condition identification and tracking as well as member-level premium claims data, and more. It provides similarly relevant metrics to other functions.

Many metrics available are cross-functionally relevant and with uniform definitions, such as for per member per month. With these payers can not only integrate, analyze and share consistent information internally but also with providers, members, vendors, and other stakeholders. For example, payers can instantly produce medical and pharmacy claims, lab results, and other member-specific information to meet CMS requirements for digital access to patient records while improving member experience.

Abacus Insights provides MyMetrics by drawing from its Data Transformation Platform which consolidates, standardizes, and validates billions of pieces of structured, semi-structured and unstructured data from multiple internal systems and external sources including labs, pharmacies, EHRs, HIEs, and digital apps. The platform enables payers to achieve a unified data foundation with digitally interoperable data that reach a new standard for usability by meeting six dimensions: accurate, complete, current, relevant, versatile, and use-case and application agnostic. MyMetrics emanate from the platform’s semantic layer.

Abacus Insights’ HITRUST CSF-certified and SOC2-certified Data Transformation Platform and Solutions are scalable, compliant, and secure. They provide 60% lower TCO and time-to-value in 4 to 6 months.

Find out more about the specific metrics and calculations that are available through MyMetrics here.

About Abacus Insights
Abacus Insights is a healthcare technology leader with the only data transformation platform and solutions built specifically for health plans. Focused on data quality and usefulness, Abacus Insights gives payers a new level of control and flexibility with their data by developing accurate, timely, and robust ecosystems that can support any analytics or other applications. Managing data for 21 million members, Abacus Insights partners with payers to deliver scalable solutions that drive strategic initiatives, control costs, and improve member lives and experiences.

Media Contact:
Lois Padovani
padovanilois@hipposhealth.com
773.501.8744