Abacus Insights Certified as CMS Qualified Entity, Part of Federal Program Aimed at Using Data to Improve Provider Quality and Health Outcomes for Patients

Company Also Releases Solution to Help Health Plans Comply with CMS Interoperability Mandate and Use Data as a Catalyst for Innovation

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.

The QE program is also known as the Medicare Data Sharing for Performance Measurement Program. It enables organizations that meet strict requirements for data security and privacy, as well as specialized expertise in quality performance measurement, to receive Medicare Parts A and B medical claims data and Part D prescription event drug data. Certified entities are then able to use that data to evaluate the performance of providers, a key part in the nationwide effort to improve the quality of healthcare.

The company also announced the release of the Abacus CMS Interoperability Solution, a secure data management and API delivery platform that will enable health plans to comply with the CMS Interoperability mandate and also turn volumes of patient data into valuable insights for patients, healthcare providers, researchers and digital health innovators.

“As a CMS Qualified Entity, we are being entrusted with data that has enormous potential for improving the quality of healthcare and outcomes for patients across the country,” said Dr. Minal Patel, CEO of Abacus Insights. “As one of the nation’s leading experts in data integration and interoperability, we can also help health plans meet the CMS Interoperability mandate by liberating their data and making it shareable with patients and other important stakeholders. Our solution will help them accomplish this, but it will do far more than that. It will enable health insurers to spur a whole new wave of innovation when they become adept at analyzing and sharing this valuable information across multiple stakeholders. This is truly a rare case where compliance and transformation go hand in hand.”

The company’s platform offers an intelligent, feature-rich, and security-focused foundation. The platform’s key features include comprehensive data management, HL7 FHIR-based API delivery, a data ecosystem of connectors for onboarding diverse datasets, analytics enablement, data profiling and diagnostic reports, advanced security features and platform flexibility for customer-specific extensions.

The Abacus CMS Interoperability platform will ingest data from CMS for millions of Medicare beneficiaries and integrate it with other data sources, including medical and pharmacy claims, lab results, clinical data from EMRs, digital and other consumer-generated data. The secure platform then further enriches the data using its proprietary and third-party tools. Health plans can then use the platform to generate new insights helping consumers make better health choices and deliver more personalized health experiences, as well as enable providers to make more informed decisions by having a more complete picture of their patient.

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. 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.


Rob Cronin