Improve Data Usability and Accuracy to Drive Performance Toward Better Health Outcomes

Our suite of solutions revolutionizes how payers can use data for faster and better decision-making.

Each solution offers payers a major step forward in data usability because we deliver only the transformed, validated data you need to manage and optimize your specific business functions.

The benefit? Business unit leaders can have confidence that the data informing their decisions are correct, up-to-date, complete, and aligned with their company’s goals.

CIOs and CTOs gain more freedom in meeting their companies’ needs because our solutions increase payer control and flexibility over data use. By uncoupling data from analytics and other applications, Abacus Insights’ data solutions support any existing legacy or new payer software applications.

How We Do It

The solutions rest on our unique platform, the only cloud-based data transformation platform built specifically for health plans. It excels at making high-quality data available at optimal latency to accelerate business value for both analytical and operational use.

A foundation of integrated and validated payer and external data is the prerequisite to powerful, targeted solutions that enable payers to drive effectiveness, efficiency, and innovation toward improving clinical outcomes.

Our Data Solutions

We’re focusing on data solutions needed to power key payer operations and initiatives.

CMS Interoperability

CMS Interoperability

Enables compliance with the Centers for Medicare and Medicaid Services’ requirements for interoperability for patient access.

Risk Adjustment

Risk Adjustment

Unifies and delivers timely data for effective risk adjustment of government-sponsored plans to optimize care for high-needs members.

Clinical Data

Clinical Data

Integrates clinical, administrative, and health equity data into longitudinal member and patient records to provide a holistic view of the care journey.

Self-Funded Employers

Self-Funded Employers*

Integrates data from multiple payers and care delivery partners to create a unified view of employees and help employees and payers to better administer and manage benefits.

Pharmacy/Specialty Benefit Management

Pharmacy/Specialty Benefit Management*

Creates a unified data layer across medical and pharmacy data to power cost and quality analytics and operationally provide timely data closer to the point of care.

Behavioral Health

Behavioral Health*

Collects, cleans, and delivers unified medical, Rx, and behavioral health data from in-person and virtual care models to accelerate analytics and operationalization of care model redesign programs.

Cost-of-Care Management

Cost-of-Care Management*

Supports performance measurement and scaling of complex value-based and fee-for-service arrangements by providing current, complete, and accurate data.



As virtual health and telehealth models continue to become a core part of care delivery, this data solution enables the integration of disparate data into the payer data ecosystem to improve experience, cost, and quality processes.

Upcoming Solutions

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