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# Abacus Insights

## Sitemaps
- [XML Sitemap](https://abacusinsights.com/sitemap_index.xml): Includes all crawlable and indexable pages.

## Posts
- [NCQA 2026 Takeaways for Health Plans: 5 Quality Priorities](https://abacusinsights.com/ncqa-2026-health-plan-quality-takeaways/): By Karen Manning, RN, BSN, MBA, Director, Business Solutions, Abacus Insights
- [Health Plans: Your BI Tells You MLR Moved. Can Your AI Tell You Why?](https://abacusinsights.com/health-plan-mlr-variance-ai/): Each question requires more context than the one before it. The first needs a financial measure and a budget comparison. The second needs the components underneath the variance. The third crosses claims, membership, provider, contract, and care management data. By the fourth, the conversation has moved from financial reporting into operations. Tracing health plan MLR variance means following that path from the financial signal to its operational cause.
- [2026 Health Plan Payment Integrity Trends](https://abacusinsights.com/2026-health-plan-payment-integrity-trends/): By Sue Riddell, Director, Payer Strategy
- [Every year, your team rediscovers the same billing error. And pays for it again.](https://abacusinsights.com/insourcing-claims-editing/): You don't start from a blank page. CoverSelf ships a pre-built library covering the same ground incumbent edit libraries do, with updates that keep pace with guideline changes. From there, your team customizes native content where it fits and authors new concepts where it doesn't, with CoverSelf's built-in AI assistant generating the configuration from a plain-English description of the policy. The learning curve becomes reviewing logic instead of writing it, which changes who on your team can own this. That shift, from licensing edit logic to authoring it, is what insourcing claims editing means in practice. 
- [MESC 2026: Why Medicaid Modernization Stalls on Data](https://abacusinsights.com/mesc-2026-takeaways-medicaid-data-modernization/): By Leah Shakleton, Senior Director, Government Solutions
- [Complex Claims Audit Has a Context Problem: Why Data Assembly, Not Judgment, Slows Decisions](https://abacusinsights.com/complex-claims-audit-has-a-context-problem-why-data-assembly-not-judgment-slows-decisions/): By Tracy Delgado, CSPO, RHIA, Sr. Product Manager, Payment Integrity
- [Your AI Pilot Isn’t Failing. Your Payment Integrity Data Is.](https://abacusinsights.com/your-ai-pilot-isnt-failing-your-payment-integrity-data-is/): By Tracy Delgado, CSPO, RHIA, Sr. Product Manager, Payment Integrity
- [Abacus Insights Launches Payment Integrity Suite Built on Trusted Data](https://abacusinsights.com/payment-integrity-suite-launch/): BOSTON, Mass – August 5, 2026 –   Abacus Insights today announced the launch of its Payment Integrity Suite, three modular solutions that help health plans modernize payment integrity (PI) through trusted data, payer-controlled visibility, and AI-enabled innovation.
- [How Payment Integrity Teams Can Unlock the Promise of AI](https://abacusinsights.com/how-payment-integrity-teams-can-unlock-the-promise-of-ai/): Payment Integrity leaders are racing against rising costs and accelerating coding intensity, and AI promises to help. Early pilots show it can triage records faster, surface patterns across claims, and point analysts to where dollars are recoverable.
- [CMS-0062-P Signals the Next Phase of Interoperability](https://abacusinsights.com/cms-0062-p-signals-the-next-phase-of-interoperability/): Why Plans Can’t Treat It Like a Checkbox Exercise
- [CMS Has Spoken: Why the CY 2027 Final Rule Changes the Stakes for Star Ratings](https://abacusinsights.com/cms-has-spoken-why-the-cy-2027-final-rule-changes-the-stakes-for-star-ratings/): By Karen Manning, MBA, BSN, RN, Director, Business Solutions
- [Abacus Insights and CoverSelf Partner to Strengthen Payment Integrity for U.S. Health Plans](https://abacusinsights.com/abacus-insights-and-coverself-partner-to-strengthen-payment-integrity/): Boston & San Francisco, March 23, 2026: Abacus Insights, a leading healthcare data usability platform, and CoverSelf, a cloud-native payment integrity (PI) platform purpose-built for U.S. health plans, have announced a strategic integration that brings together configurable pre- and post-pay editing with a trusted data foundation.
- [What We Heard at HIMSS26: The Payer Perspective (3 Key Shifts)](https://abacusinsights.com/what-we-heard-at-himss26-the-payer-perspective-3-key-shifts/): But at HIMSS26, payer leaders shared plans to integrate AI into core business processes: underwriting, risk adjustment, quality improvement, payment integrity, and prior authorization.
- [CMS‑0057 Compliance: 3 Proven Models to Meet the 2027 Deadline](https://abacusinsights.com/cms-0057-compliance-3-proven-models-to-meet-the-deadline/): As health plans race to meet the Jan. 1, 2027 deadline for CMS-0057 compliance, CEOs need to stop asking their compliance teams if they’re ready and instead start probing for IT readiness.
- [How Digital HEDIS® is Powering the Shift to Value Based Care](https://abacusinsights.com/how-value-based-care-and-digital-transformation-reshape-hedis/): In our earlier blogs, we explored why manual chart abstraction is giving way to digital HEDIS and how CMS interoperability mandates are creating the data conditions for that shift. Those regulatory and technical changes matter, but they are not the end goal. The real driver is the steady move toward value-based care (VBC).
- [Powering Digital HEDIS® with the CMS Interoperability and Prior Authorization Final Rule](https://abacusinsights.com/cms-interoperability-digital-hedis/): By Karen Manning, MBA, BSN, RN, Director, Business Solutions
- [Using FHIR-Powered Analytics to Deliver the Right Care at the Right Time](https://abacusinsights.com/delivering-the-right-care-at-the-right-time/): By Vincent Tumminello and Matthew Giglia
- [The Future of HEDIS®  is Digital](https://abacusinsights.com/the-future-of-hedis-is-digital/): By Karen Manning, MBA, BSN, RN, Director, Business Solutions
- [Tech Mahindra and Abacus Insights Partner to Accelerate CMS Interoperability Compliance for U.S. Healthcare Payers](https://abacusinsights.com/tech-mahindra-and-abacus-insights-partner-to-accelerate-cms-interoperability-compliance-for-us-healthcare-payers/): Pune, September 8, 2025: Tech Mahindra (NSE: TECHM), a leading global provider of technology consulting and digital solutions to enterprises across industries and Abacus Insights, the industry leader in data usability and interoperability for U.S. healthcare payers, announced a strategic partnership to enable seamless compliance and modernize healthcare data interoperability. The partnership will streamline and accelerate the implementation lifecycle for U.S. healthcare payers required to comply with the Centers for Medicare & Medicaid Services (CMS) Interoperability and Priority Authorization Final Rule (CMS-0057-F).
- [CMS-0057-F Interoperability and Prior Authorization Final Rule is a Chance for Payers to Rewrite the Playbook for Compliance and Interoperability](https://abacusinsights.com/cms-0057-f-interoperability-and-prior-authorization-final-rule-is-a-chance-for-payers-to-rewrite-the-playbook-for-compliance-and-interoperability/): By Gokul Varadharaj, Chief Revenue Officer & Co-FounderVincent P. Tumminello, AVP, Solution StrategyDmitri Kitaynik, Director, Product Management
- [Healthcare Data Usability Leader Abacus Insights Charts Its Growth With Appointment of New Chief Operating Officer](https://abacusinsights.com/healthcare-data-usability-leader-abacus-insights-charts-its-growth-with-appointment-of-new-chief-operating-officer/): Boston, December 10, 2024—Abacus Insights, the leader in data usability for U.S. payers, today announced the promotion of John Pyhtila, PhD., Chief Product and Strategy Officer, to Chief Operating Officer, effective immediately. As COO, Pyhtila will oversee product, delivery and customer success, as well as client data engineering teams, and report to Abacus Insights Founder & CEO Minal Patel, MD.
- [Abacus Insights Expands CMS Interoperability Data Solution Suite to Accelerate Payer Readiness to Meet Complex CMS-0057-F Government Mandates Starting in January 2026](https://abacusinsights.com/abacus-insights-expands-cms-interoperability-data-solution-suite-to-accelerate-payer-readiness-to-meet-complex-cms-0057-f-government-mandates-starting-in-january-2026/): Boston, November 14, 2024—Abacus Insights, the leader in data usability for U.S. payers, is expanding its industry-leading CMS Interoperability data solution to enable health plans to comply with the Centers for Medicare and Medicaid Services’ latest and most ambitious mandate, CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). Built on Abacus Insights’ usable data platform for payers, the solution is fully integrated with the CMS interoperability platform of Onyx, bringing to market a new suite of turnkey compliance modules that enables payers to meet CMS-0057-F requirements seamlessly and cost-effectively, starting with the looming early 2026 metrics reporting deadline.
- [enGen and Abacus Insights Collaborate to Enhance Client Value of enGen’s Growing Suite of Industry-Leading Payer Solutions](https://abacusinsights.com/engen-and-abacus-insights-collaborate-to-enhance-client-value-of-engens-growing-suite-of-industry-leading-payer-solutions/): Boston, November 6, 2024—Healthcare technology innovator enGen and Abacus Insights, the leader in data usability for U.S. payers, today unveiled their collaboration on next-generation platforms and solutions that enable health plans to increase efficiency, reduce costs, improve member care, meet regulatory mandates and realize other enterprise priorities.
- [Discover How a Blues Payer Revamped Their Data Strategy To Navigate the Shifting Medicare Advantage Landscape](https://abacusinsights.com/discover-how-a-blues-payer-revamped-their-data-strategy-to-navigate-the-shifting-medicare-advantage-landscape/): With growing challenges for Medicare Advantage plans, one Blues plan has built next-level data-driven capabilities to become more agile and responsive. The key: upgrading to a foundation of usable data and analytics for driving improved Star ratings and enterprise performance.
- [Blog: Generative AI Favors Incumbent Payers Over Disrupters](https://abacusinsights.com/blog-generative-ai-favors-incumbent-payers-over-disrupters/): By John Pyhtila, PhD, Chief Product and Strategy Officer and Gokul Varadharaj, Chief Revenue Officer & Co-Founder
- [Video: Data-Driven Pharmacy Management Levels Up](https://abacusinsights.com/video-data-driven-pharmacy-management-levels-up/): Processing upwards of $70 billion in pharmacy transactions for 1 in 6 U.S. healthcare consumers, leading PBM Prime Therapeutics has grown rapidly in recent years to not only serve its 19 Blues plan owners but more than 80 other health plans.
- [Increase Medicare Star Ratings with Insights-Ready Data™ from Abacus Insights’ Stars Performance Data Solution](https://abacusinsights.com/increase-medicare-star-ratings-with-insights-ready-data-from-abacus-insights-stars-performance-data-solution/): Boston, August 22, 2024--Abacus Insights, the leader in data usability for U.S. payers, is launching its breakthrough Stars Performance Data Solution to equip payers with the insights-ready dataTM to accelerate improvement in quality outcomes and member and provider experience, which will in turn boost Medicare Star Ratings. The data solution eliminates the current heavy burden of regularly wrangling data from multiple sources and manually integrating results across vendors and formats, empowering payers to focus more on executing interventions that result in improved quality, enhanced experience, and better Star Ratings.
- [Video: Finance and Tech – The Critical Payer Partnership](https://abacusinsights.com/video-finance-and-tech-the-critical-payer-partnership/): From changing rates for reimbursement, risk adjustment, utilization, care costs and more, payer finance operations face a formidable task in setting the right course in underwriting, risk and other operations for their health plans.
- [Blog: Five Criteria for Choosing Initial Payer GenAI Use Cases](https://abacusinsights.com/blog-five-criteria-for-choosing-initial-payer-genai-use-cases/): By John Pyhtila, PhD, Chief Product and Strategy Officer and Gokul Varadharaj, Chief Revenue Officer & Co-Founder
- [Video: Powering Accountable Care with Better Data and Analytics](https://abacusinsights.com/video-powering-accountable-care-with-better-data-and-analytics/): Payers face growing pressure to develop effective population health models due to increasing utilization, slowing reimbursements and CMS proceeding with its plans to move all Medicare beneficiaries to accountable care or value-based care arrangements by 2030. In this Health Planning video, Abacus Insights CEO Minal Patel, MD and Mohamed Diab, MD, President of CVS Accountable Care, with 70,000+ providers and 1 million attributed lives in Medicare risk-sharing models in rural, suburban and urban geographies across the United States, discuss the need for more and better data, including social determinants, and other keys to success in accountable care.
- [Blog: Four GenAI Development Requirements for Payers to Realize Strategic Value](https://abacusinsights.com/blog-four-genai-development-requirements-for-payers-to-realize-strategic-value/): By John Pyhtila, PhD, Chief Product and Strategy Officer and Gokul Varadharaj, Chief Revenue Officer & Co-Founder
- [Blog: Payer-Customized Generative AI Models Deliver Strategic Impact](https://abacusinsights.com/blog-payer-customized-generative-ai-models-deliver-strategic-impact/): By John Pyhtila, PhD, Chief Product and Strategy Officer and Gokul Varadharaj, Chief Revenue Officer & Co-Founder
- [Blog: Payers, You Deserve Better Clinical Data. Here’s How to Get It.](https://abacusinsights.com/blog-payers-you-deserve-better-clinical-data-heres-how-to-get-it/): By Vincent P. Tumminello, Senior Director, Solution Strategy
- [Video: Overcome Data Failures to Drive MA Success](https://abacusinsights.com/video-overcome-data-failures-to-drive-ma-success/): With utilization rising and risk adjustment audits increasing, Medicare Advantage plans need to better understand and treat different older adult populations. In this Health Planning video, Abacus Insights CEO Minal Patel, MD and Sachin H. Jain, MD, CEO of the non-profits SCAN Group, recognized leader in senior care and SCAN Health Plans, which offers leading MA plans in five states, discuss the role of data in enabling improved segmentation and care interventions. Tune in for the discussion.
- [Video: Address Data Bias To Ensure Equitable Older-Adult Care](https://abacusinsights.com/video-address-data-bias-to-ensure-equitable-older-adult-care/): Incomplete and biased health data is perpetuating care disparities, which may grow worse if payers train new AI apps on this data. In our latest Health Planning Video, Abacus Insights CEO, Minal Patel MD discusses the issue of data bias with Sarita Mohanty, MD, CEO of The SCAN Foundation, an organization dedicated to reducing care gaps for older adults. Hear her perspective on the impact of data bias on the aging population and the important role payers can play in overcoming it.
- [Video: Blue Cross NC Succeeds With Data-Driven VBC](https://abacusinsights.com/video-blue-cross-nc-succeeds-with-data-driven-vbc/): Since the inception of its value-based care initiative in 2019, state plan Blue Cross NC generated $650m in savings that it was able to channel back into provider and member benefits, improving care.
- [Risk Adjustment Gets Usable Data at Last](https://abacusinsights.com/risk-adjustment-gets-usable-data-at-last/): Overcoming the challenge of getting usable data for your Risk Adjustment team is a far too familiar challenge for payers, but it doesn’t have to be that way. While risk adjustment is estimated to represent one-third of payer revenues and is, therefore, a pressing priority, more urgent technology and data needs often take precedence.
- [Video: Behavioral Health: An Overlooked Opportunity for Payers](https://abacusinsights.com/behavioral-health-overlooked-opportunity-for-payers/): In this episode of Health Planning, an executive insight series for payer executives, Abacus Insights’ CEO Minal Patel, MD and Reena Pande, MD, former Chief Medical Officer of virtual behavioral health provider AbleTo, discuss how payers can improve member outcomes and lower costs by prioritizing behavioral health. With access to the right data, they can accurately identify patients in need, help them receive the right care and improve their own efficiencies.
- [Blog: A Faster Route to Getting the Most From Medical Cost Management Vendors](https://abacusinsights.com/a-faster-route-to-getting-the-most-from-medical-cost-management-vendors/): As payers face sharply rising cost pressures, it’s tempting to take a Whack-A-Mole approach to medical cost management vendors. Time is of the essence to keep medical costs from outpacing premiums. Health plans are expecting the highest cost trends in two decades, according to PWC, with commercial cost trend hitting 9% increase in 2027.
- [Abacus Insights Joins the AWS ISV Accelerate Program](https://abacusinsights.com/abacus-insights-joins-the-aws-isv-accelerate-program/): Boston, November 9, 2023—Abacus Insights, the leader in data usability for U.S. healthcare payers, has expanded its relationship with Amazon Web Services (AWS) by joining the AWS Independent Software Vendor (ISV) Accelerate Program, a co-sell program for organizations that provide software solutions that run on or work with AWS. The program helps AWS Partners drive new business by directly connecting participating ISVs with the AWS Sales organization.
- [Abacus Insights Appoints New Independent Board Director](https://abacusinsights.com/abacus-insights-appoints-new-independent-board-director/): Boston, October 31, 2023—Abacus Insights, the leader in data usability for U.S. healthcare payers, is pleased to announce that it has added William McIvor to its board of directors. McIvor brings deep experience in launching, scaling and managing fast-growing healthcare businesses, health plans, technologies, services and products.
- [Abacus Insights’ Data Solutions for Payers Are Now Natively Available on Snowflake](https://abacusinsights.com/abacus-insights-data-solutions-for-payers-are-now-natively-available-on-snowflake/): Boston, September 20, 2023—Abacus Insights, the leader in data usability for U.S. healthcare payers, offers a breakthrough with bi-directional data sharing for more than 25 use cases including risk adjustment, CMS interoperability, clinical data exchange, cost-of-care management, HEDIS and STAR reporting, pharmacy/specialty benefit management, ASO carve-out and others. As Abacus Insights steadily adds use cases through its expanding array of data solutions natively available on Snowflake, payers including Cambia Health Solutions and Blue Cross Blue Shield of Massachusetts are accelerating and amplifying the business value of usable data from Abacus Insights made accessible via Snowflake’s Data Cloud.
- [How to Get Interoperable Usable Data to Transform Risk Adjustment](https://abacusinsights.com/how-to-get-interoperable-usable-data-to-transform-risk-adjustment/): As Medicare Advantage and other government-sponsored value-based plans grow in importance and reach, so does the role of risk adjustment for payers and their members, providers, vendors and other stakeholders.
- [How Payers Can Overcome Legacy Constraints to Drive Business Value on the Cloud](https://abacusinsights.com/how-payers-can-overcome-legacy-constraints-to-drive-business-value-on-the-cloud/): Health plans eager to improve member care, equity, outcomes and experiences are too often hampered by siloed legacy systems and unreliable and incomplete healthcare data needed to analyze the business, make decisions and share with providers, patients and vendors. Blue Cross Blue Shield of Massachusetts (BCBSMA) overcame these issues with cloud platforms, interoperable usable data and analytics. BCBSMA and strategic partners AWS, Abacus Insights and ZS discuss this type of technology and data transformation for payers and its benefits to performance in core operations, analytics and innovation.
- [Where Does a Health Plan Start on a Data Cloud Journey?](https://abacusinsights.com/where-does-a-health-plan-start-on-a-data-cloud-journey/): Learn how Cambia Health Solutions created a unified data foundation with Abacus Insights and Snowflake to drive business value ranging from member experience to clinical integration.
- [Cambia Health Solutions’ Major Data Transformation Puts Members at the Center of Care](https://abacusinsights.com/cambia-health-solutions-case-study/): Cambia Health Solutions committed to making its mountains of data more usable and shareable across its ecosystem--for employees, members, providers, vendors and other stakeholders. Its aim: Serve members and their families in a much more personal way. First, though, the provider of leading Blues plans needed scalable and extensible technology to create a unified data model and platform that makes data truly usable.
- [Abacus Insights Enables Health Plans to Track Total Cost of Care Throughout the Claims Process](https://abacusinsights.com/abacus-insights-enables-health-plans-to-track-total-cost-of-care-throughout-the-claims-process/): Boston, May 9, 2023 – Abacus Insights, the leader in data usability for healthcare payers, is introducing a data solution that better enables health plans to calculate and monitor their total cost of care in real-time and across all lines of business throughout the claims process. As a result, payers can closely track costs to target care for all members, address higher than expected claims and ensure sufficient reserves.
- [Health Plan Efforts to Meet CMS Interoperability Mandates and Leverage Data Toward Health Improvements Get a Boost from a New Industry Partnership](https://abacusinsights.com/health-plan-efforts-to-meet-cms-interoperability-mandates-and-leverage-data-toward-health-improvements-get-a-boost-from-a-new-industry-partnership/): Boston and Elkridge, MD, April 25, 2023--Abacus Insights' and Onyx Technology's new partnership provides an immediate solution for payers needing to close the gap on complying with state and federal mandates for data interoperability. It also strengthens payers’ ability to support new consumer-driven and value-based models of healthcare.
- [Abacus Insights Earns HITRUST Risk-Based, 2-Year Recertification of Its Data Transformation Platform](https://abacusinsights.com/abacus-insights-earns-hitrust-risk-based-2-year-recertification-of-its-data-transformation-platform/): Boston, March 23, 2023 – Abacus Insights, the leader in data usability for healthcare payers, has earned the HITRUST r2 certification for its Data Transformation Platform hosted at Amazon Web Services (AWS) and Active Directory hosted at Microsoft Azure. For the recertification, Abacus Insights demonstrated that it met the gold standard for regulatory compliance, industry requirements and risk management.
- [Usable Data is the Key to Realizing the Promise of AI in Healthcare](https://abacusinsights.com/usable-data-is-the-key-to-realizing-the-promise-of-aiin-healthcare/): By: Navdeep Alam, Chief Technology Officer, Abacus Insights
- [3 Fallacies About Healthcare Technology’s Buy vs. Build Dichotomy](https://abacusinsights.com/3-fallacies-about-healthcare-technologys-buy-vs-build-dichotomy/): By Minal Patel, MD, Founder and CEO, Abacus Insights
- [The Goal for Healthcare Data Needs to Move Beyond Quality to Usability](https://abacusinsights.com/the-goal-for-healthcare-data-needs-to-move-beyond-quality-to-usability/): By Minal Patel, MD, Founder and CEO, Abacus Insights
- [ZS and Abacus Insights Announce Partnership To Bring Innovative Data and Analytics Solutions to Health Plans](https://abacusinsights.com/zs-and-abacus-insights-announce-partnership-to-bring-innovative-data-and-analytics-solutions-to-health-plans/): EVANSTON, Ill. and BOSTON, Mass. – November 29, 2022 –  As ZS continues to help health plans evolve and transform, the firm announced today an investment in and partnership with Abacus Insights, a healthcare technology leader with a groundbreaking offering in data usability that rapidly accelerates the achievement of key health plan goals including efficiency, equity, health services and member outcomes.
- [Abacus Insights Partners with Blue Cross Blue Shield of Massachusetts to Accelerate Healthcare Data Transformation](https://abacusinsights.com/abacus-insights-partners-with-blue-cross-blue-shield-of-massachusetts-to-accelerate-healthcare-data-transformation/): Boston, November 15, 2022—Abacus Insights has partnered with Blue Cross Blue Shield of Massachusetts (“Blue Cross”) to launch a new data strategy centered around exceptional consumer experiences and innovation in care and outcomes. Working together, Abacus Insights and Blue Cross have achieved a significant milestone by delivering updated data to members, providers, and business units in 15 minutes or less—down from 8 to 24 hours earlier this year and as long as one week in 2021. This latest achievement in data transformation encompasses Blue Cross’ mission-critical objectives, including unparalleled member experiences, quality, equity, and affordability.
- [Abacus Insights Announces New Chief Financial Officer](https://abacusinsights.com/abacus-insights-announces-new-chief-financial-officer/): Boston, November 1, 2022— Healthcare technology leader Abacus Insights has appointed Frank Hunt as its Chief Financial Officer effective November 1, 2022. Hunt joins Abacus Insights, a leader in healthcare data usability, at a critical period of growth for the company, bringing a demonstrated track record of fund-raising and financial leadership in healthcare services and insurance.
- [Abacus Insights’ Clinical Data Solution Offers Health Plans a Breakthrough in Creating Longitudinal Patient Records to Improve Care](https://abacusinsights.com/abacus-insights-clinical-data-solution-offers-health-plans-a-breakthrough-in-creating-longitudinal-patient-records-to-improve-care/): Boston, September 13, 2022— Abacus Insights, a healthcare technology leader with the only cloud-based data transformation platform built specifically for health plans, is rolling out a data solution that enables health plans to create comprehensive longitudinal patient records. The Clinical Data Solution does so by integrating and validating structured and unstructured clinical data from HIEs, EMRs, member devices and apps, as well as other external sources with core payer data including claims eligibility and case management, which offers an expanded foundation for improving member care and outcomes.
- [Abacus Insights Delivers Data Solution for Healthcare Payers to Improve Risk Adjustment Accuracy](https://abacusinsights.com/abacus-insights-delivers-data-solutionf-for-healthcare-payers-to-improve-risk-adjustment-accuracy/): Boston, August 30, 2022—Abacus Insights, a healthcare technology leader with the only cloud-based data transformation platform built specifically for health plans, has launched a data solution that enables accurate risk adjustment for government-sponsored health plans. Abacus Insights’ Risk Adjustment Solution simplifies the rapidly escalating complexity of scoring and calculating risk by delivering correct, complete, and timely data tailored for each health plan.
- [Abacus Insights Takes Healthcare Data to New Levels of Value with Solutions Tailored to Key Payer Business Operations](https://abacusinsights.com/abacus-insights-takes-healthcare-data-to-new-levels-of-value-with-solutions-tailored-to-key-payer-business-operations/): Boston, August 16, 2022—Abacus Insights, a healthcare technology leader with the only cloud-based data transformation platform built specifically for health plans, is rolling out a suite of solutions that revolutionizes how payers can leverage data for faster and better decision making.
- [Abacus Insights, Leader in Health Plan Data Solutions, Raises $28 Million Series C Financing](https://abacusinsights.com/abacus-insights-leader-in-health-plan-data-solutions-raises-28-million-series-c-financing/): About Abacus Insights
- [To Realize the Promise of AI, Healthcare Must Focus First on Quality Data](https://abacusinsights.com/to-realize-the-promise-of-ai-healthcare-must-focus-first-on-quality-data/): By: Navdeep Alam, Chief Technology Officer, Abacus Insights
- [Built In Honors Abacus Insights in its Esteemed 2022 Best Places To Work Awards](https://abacusinsights.com/built-in-honors-abacus-insights-in-its-esteemed-2022-best-places-to-work-awards/): Boston, MA — January 6, 2022 — Built In announced that Abacus Insights was honored in its 2022 Best Places to Work Awards. Specifically, Abacus Insights earned a place on 100 Best Places to Work, 50 Best Small Companies, 50 Best Paying Companies, and 50 Best Benefits in Boston. The annual awards program includes companies of all sizes, from startups to those in the enterprise, and honors both remote-first employers as well as companies in the eight largest tech markets across the U.S.
- [Developing a Resilient Data Management Strategy in a Shifting Market](https://abacusinsights.com/developing-a-resilient-data-management-strategy-in-a-shifting-market/): By: Minal Patel, CEO of Abacus Insights
- [Massachusetts: Leading the Nation in Healthcare Interoperability](https://abacusinsights.com/massachusetts-leading-the-nation-in-healthcare-interoperability/): By Minal Patel, CEO of Abacus Insights
- [From Med School to Tech Entrepreneur, Abacus Insights CEO Minal Patel Tackles Old Guard Healthcare with Data](https://abacusinsights.com/from-med-school-to-tech-entrepreneur-abacus-insights-ceo-minal-patel-tackles-old-guard-healthcare-with-data/): When Minal Patel first entered medical school, his aspiration was to solve health problems and make an impact in patients’ lives. Almost three decades later Patel is doing exactly that, but in a very different way than he ever imagined.
- [Speaking Of, Making Healthcare Work for You: Interview with Minal Patel, CEO & Founder of Abacus Insights](https://abacusinsights.com/1248-2/): The talk show "Speaking Of, Making Healthcare Work for You" features innovators in healthcare. Our CEO, Minal Patel, was interviewed and discussed how harnessing the power of data can provide insights for health plans and improve patient outcomes.
- [Why Knowing John Doe From J. Doe Is So Important in Healthcare](https://abacusinsights.com/why-knowing-john-doe-from-j-doe-is-so-important-in-healthcare/): Sumant Rao, Chief Product Officer and Justin Chang, Product Manager
- [Abacus Insights Platform Overview](https://abacusinsights.com/overview-slick/): The Abacus Insights Platform: Healthcare Data. Simplified.
- [Interoperability Solution Overview](https://abacusinsights.com/interop-solution-slick/): Payers have been challenged with creating a modernized ecosystem where healthcare data quality is managed and made available for analytics and other business objectives. With the CMS Interoperability and Patient Access Rule, payers are now mandated to improve how data is exchanged and shared with their patients and providers
- [Quality Connections Matter](https://abacusinsights.com/quality-connections-matter/): Sumant Rao, Chief Product Officer and Dan Reardon, Sr. Director, Product Management
- [Inside the Most Challenging Data Problem in Healthcare](https://abacusinsights.com/inside-the-most-challenging-data-problem-in-healthcare/): Payer data is one of the most exciting assets in healthcare, holding the most promise for dynamic, meaningful change to the way care is delivered and paid for. It’s also the most challenging data problem to exist in the industry.
- [CMS’ Data Interoperability Rule Can Spur Innovation for Payers, Experts say. Here’s How](https://abacusinsights.com/cms-data-interoperability-rule-can-spur-innovation-for-payers-experts-say-heres-how/): On July 1, a final rule by the Centers for Medicare & Medicaid Services (CMS) took effect that opens up patient access to healthcare data.
- [CIO Case Study](https://abacusinsights.com/cio-case-study/): A Focus on Data Transformation Leads to Accelerated Time to Value for a Regional ‘Blue’ Health Plan
- [Abacus Insights and FHIR Works on AWS Provide Co-engineered 21st Century Cures Act solution](https://abacusinsights.com/abacus-insights-and-fhir-works-on-aws-provide-co-engineered-21st-century-cures-act-solution/): This blog was co-authored by Angus McAllister, Product Owner of Open Source Healthcare Interoperability at AWS, and Art Huston, Engineering Manager at Abacus Insights.
- [Interoperability Checklist – Are You Ready?](https://abacusinsights.com/interoperability-checklist-are-you-ready/): It’s been over a year of anticipation, but the Centers for Medicare and Medicaid’s Interoperability and Patient Access Final Rule is finally coming into effect. The implementation of this long-awaited mandate, which will allow patients to request and have access to their medical data to share with plans, providers, and digital applications, represents a new horizon for health plans, rife with opportunity for innovation. There are also a bevy of implications for plans if they fail to comply with the mandate.
- [New CMS Data Interoperability Rule Takes Effect July 1](https://abacusinsights.com/new-cms-data-interoperability-rule-takes-effect-july-1/): The rule aims to free data from silos to promote interoperability between payers and providers.
- [Data Reveals Institutional Racism in Healthcare Still Exist, But Providers/Payers Can Change That](https://abacusinsights.com/healthdisparities/): Newscasters sounded surprised when they announced for the first time that COVID-19 was disproportionately affecting Black, Indigenous, and people of color. As they presented graphs that showed higher rates of infection, hospitalization, and death, their tone was one of mild shock.
- [Abacus Insights Extends Core Capabilities of Interoperability Platform To Support CMS Mandate](https://abacusinsights.com/abacus-insights-extends-core-capabilities-of-interoperability-platform-to-support-cms-mandate/): 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.
- [Abacus Insights Appoints Navdeep Alam Chief Technology Officer](https://abacusinsights.com/abacus-insights-appoints-navdeep-alam-chief-technology-officer/): 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, today announced the appointment of Navdeep Alam as chief technology officer (CTO).
- [Abacus Insights Achieves HITRUST CSF® to Manage Risk, Improve Security Posture, and Meet Compliance Requirements](https://abacusinsights.com/abacus-insights-achieves-hitrust-csf-to-manage-risk-improve-security-posture-and-meet-compliance-requirements/): 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, today announced that the Abacus Platform, hosted by Amazon Web Services (AWS), has earned Certified status for information security by HITRUST.
- [Abacus Insights Strikes Cloud Partnership with Snowflake to Help Payers Scale Up Data Analytics](https://abacusinsights.com/abacus-insights-strikes-cloud-partnership-with-snowflake-to-help-payers-scale-up-data-analytics/): Cloud company Snowflake continues to build out partnerships with health IT companies as it ramps up competition with Amazon, Microsoft and Google in the healthcare space.
- [Health Plans Must Go Beyond the ONC Mandate and Prioritize Member Experience](https://abacusinsights.com/health-plans-must-go-beyond-the-onc-mandate-and-prioritize-member-experience/): We are all frustrated when there’s a glitch with our online banking, or if bandwidth problems interfere with streaming the movie we want to watch. Imagine how individuals will react when the results of a cancer screening don’t find their way into Apple Health or Google Health, where such information is supposed to be easy to find. Or worse, if an individual is given the wrong information about a cancer diagnosis.
- [Abacus Insights Named Built-In 100 Best Places to Work in Boston](https://abacusinsights.com/abacus-insights-named-built-in-100-best-places-to-work-in-boston/): 100 BEST PLACES TO WORK IN BOSTON 2021
- [Moving From Legacy HIT to the Future: Cambia Health’s Consumer-Driven Push](https://abacusinsights.com/moving-from-legacy-hit-to-the-future-cambia-healths-consumer-driven-push/): At many health insurer organizations across the U.S., the legacy mainframe technology systems that have been in place are becoming innovation bottlenecks, resulting in payers, providers and patients not being able to benefit from health data in the most efficient way possible.
- [Abacus Insights Named to the 2020 CB Insights Digital Health 150 — List of Most Innovative Digital Health Startups](https://abacusinsights.com/abacus-insights-named-to-the-2020-cb-insights-digital-health-150-list-of-most-innovative-digital-health-startups/): The 2020 Digital Health 150 cohort highlights startups that are reimagining the lines of the traditional healthcare experience across 12 categories, from Virtual Care Delivery and Clinical Trials, to Drug Discovery and Specialty Care. Countries represented this year include Canada, China, Israel, France, the United Kingdom, and the United States, among others.
- [Abacus Insights Certified as CMS Qualified Entity, Part of Federal Program Aimed at Using Data to Improve Provider Quality and Health Outcomes for Patients](https://abacusinsights.com/abacus-insights-certified-as-cms-qualified-entity-part-of-federal-program-aimed-at-using-data-to-improve-provider-quality-and-health-outcomes-for-patients/): BOSTON--(BUSINESS WIRE)--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, today announced it has been certified by the Centers for Medicare and Medicaid Services (CMS) Qualified Entity (QE) Program.
- [Abacus Insights Raises $35 Million in Series B Financing to Help Health Plans Liberate Data, Enabling Consumers to Make Better Health Choices and their Providers to Offer More Informed Recommendations](https://abacusinsights.com/abacus-insights-raises-35-million-in-series-b-financing-to-help-health-plans-liberate-data-enabling-consumers-to-make-better-health-choices-and-their-providers-to-offer-more-informed-recommendations/): BOSTON--(BUSINESS WIRE)--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, today announced it has raised a $35 million Series B round from new and returning investors. The latest round was led by new investor, Blue Venture Fund, and joined by returning investors CRV, .406 Ventures, Horizon Healthcare Services Inc., and Echo Health Ventures, a strategic collaboration of Cambia Health Solutions and Mosaic Health Solutions. The debt facility was provided by J.P. Morgan.
- [Healthcare Data Integration Startup Abacus Insights Lands $12.7M Series A](https://abacusinsights.com/healthcare-data-integration-startup-abacus-insights-lands-12-7m-series-a/): Abacus Insights, an early-stage startup that wants to help coordinate healthcare information across systems, announced a $12.7 million Series A investment today led by CRV. Existing investors 406 Ventures and Echo Health Ventures also participated in the round.

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