June 8, 2021

Press Releases

Abacus Insights Extends Core Capabilities of Interoperability Platform To Support CMS Mandate

Participation in HL7 Connectathon validates company’s approach to interoperability


BOSTON, June 8, 2021 — Abacus Insights, a leading data integration and interoperability platform that enables health plans and their providers to create a more personalized healthcare experience for consumers, is continuing to expand its interoperability solution with enhancements that improve data sharing and data management for health plan clients.

Recently, federal officials finalized a series of rules that make it easier for patients to access their medical data electronically and share it with providers and other applications. Abacus Insights’ data platform is helping health plans and health systems comply with the Centers for Medicare and Medicaid Services’ (CMS) interoperability rule before it goes into effect in July.

“Abacus Insights’ interoperability solution is being implemented rapidly at health plans across the country,” said Minal Patel, CEO and Founder, Abacus Insights. “In addition, we have extended the core capabilities of our platform to support the CMS mandate, have added the ability to interchange data using FHIR APIs, and have added functionality allowing payers to control the provisioning and deprovisioning of applications.”

Abacus Insights’ data platform standardizes, curates and enriches valuable healthcare data that is currently sitting idle, moving it out of restrictive silos, and securely into the cloud. The connected and standardized platform enables health plans to integrate and share data with doctors’ offices, hospitals, urgent care clinics, pharmacies, dialysis centers, and labs along with numerous digital health applications. The platform also enables secure connections to digital health applications and wearables.

Among the enhancements announced today:

  • a FHIR server and transformation engine that enables the platform to share data using FHIR application programming interfaces (APIs) as well as support for SMART on FHIR. The platform can also ingest data in a FHIR format from multiple sources;
  • a portal for third-party developers to register their applications, for example wellness applications, and be able to access clinical, claims and other environments managed on behalf of health plans;
  • a portal for health plan administrators to easily review and manage application registration requests.

Using the Abacus Insights platform, health plans can transition away from the antiquated practice of sharing incomplete, inaccurate and often redundant health data with members and begin sharing health information that is complete, reliable and interoperable. For example, with the enhanced application provisioning capabilities for administrators, health plans will be able to more securely manage third-party applications to protect health data.

Last month, Abacus Insights participated in the HL7 Connectathon. Through real-world testing of the CARIN IG for Blue Button, the Abacus Insights platform connected successfully to third-party vendor applications and gleaned new insights that will lead to further improvements to the platform’s Developer Portal and API queries.

“The interoperability mandate is a major step forward in enabling patients to more effectively manage their health, but it is extremely complex for health plans to meet due to the data management challenges from existing infrastructures,” Minal said. “In addition, data quality should be embedded into the process of management. With the mandate, health plans have an opportunity to not just meet the requirements, but transform the member experience.”

While some health plans are working to build their own interoperability infrastructure, others are seeking technology partners to help them create solutions to ingest, manage, and share data. In order to ensure that patients have access to data using third-party applications and APIs, CMS published the HL7 FHIR Implementation Guides that health plans should use to enable their data to be shared with third-party applications. If the APIs are not aligned, it’s possible that data will not be able to be shared with patients and pose security risks.

“Abacus Insights has thoroughly reviewed the Implementation Guides and built several layers of configurability to make sure our clients have a trusted partner who stays updated with the mandate and builds the rules into the platform,” said Anusha Tomar, Head of Interoperability Products, Abacus Insights. “We have leveraged our underlying data foundations to ensure high-quality member matching and compliance, enabling health plans to serve their members confidently.”

About Abacus Insights

Abacus Insights enables health plans to offer a seamless, personalized care experience for members by reconciling thousands of unique attributes about individual consumers and their health that legacy systems simply cannot. Today, Abacus Insights with its health plan clients manage data for more than 10 million members and 15 million consumers. We allow health plans to fulfill a critical role in ensuring that when a member visits the doctor’s office, lab, pharmacy, specialist, hospital and even at home — the care provider always knows who they are, creating an “n-of-1” experience for all. For more information, please visit www.abacusinsights.com, LinkedIn, or Twitter @abacusinsights.



Sandra Katz
120/80 MKTG