![]() The Abacus platform can add data about members searching the payer website or calling a service representative about whether a specific procedure is covered. To improve claims cost planning and projections, Abacus Insights also can mine and incorporate other valuable information before, during and after care. ![]() The usable data for claims also can be segmented and analyzed by line of business, product, geography, or other variables. It gives payers the information and insights they need to pursue key goals, from increasing preventative and early interventions for highly acute members and those with chronic conditions to working with providers to reducing out-of-network referrals,” said Minal Patel, CEO and founder of Abacus Insights.Įliminating the lags and gaps in claims information improves a host of core operations and analytics, including:ĭesigning and pricing value-based care arrangements and health-plan productsĭeveloping risk scores for Medicare and ACA lines of businessĪbacus Insights’ Cost of Care Management Solution pulls, consolidates and validates claims data wherever it is in the process, including pharmacy benefit managers, utilization management companies, delegated entities and other vendors and providers, so payers know how much has been paid or committed to spend at any moment in time, including by its delegated vendors. “This usable data on claims and the cost of care is foundational for improving quality and member experience and outcomes while controlling costs. For a plan with 100,000 Medicare members and 100,000 commercial members, reducing annual cost of care by 1% would generate more than $14 million in savings. Medical costs account for 85 to 87 cents of every $1 spent by payers. As a result, payers can closely track costs to target care for all members, address higher than expected claims and ensure sufficient reserves. “Abacus Insights meets this challenge by bringing together data from various native sources and ensuring data quality quickly for its customers.BOSTON-( BUSINESS WIRE)- 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. “Abacus Insights’ modular solutions help to solve one of the biggest challenges in healthcare for payers and specialty benefits companies, including PBMs - managing data and its integration in a scalable and timely manner at a low cost,” said Licursi. He also held leadership roles at Entuity, Inc. At Zipari, he led the company’s business strategies for defined sales target markets and the product’s messaging and value proposition. Licursi spent seven years at Zipari, a customer experience platform built for the health insurance industry, where he was a co-founder and CRO. He brings 30 years of experience in sales and marketing at technology firms. ![]() Licursi will oversee Abacus Insights’ go-to-market and growth strategies through sales and marketing initiatives. He is a seasoned leader and will be an asset to our overall success.” ![]() “Peter brings extensive experience at early-stage companies focused on payers, providers and members. “Abacus Insights is continuing to drive growth and market expansion through the addition of Peter Licursi as CRO,” said Minal Patel, M.D., founder and chief executive officer. Licursi brings expertise in leading go-to-market strategies for continued growth at digital health companiesĪbacus Insights, a leading healthcare data management and interoperability solution provider enabling payers to accelerate value-based care, member engagement and digital transformation initiatives, today announced the appointment of Peter Licursi as chief revenue officer (CRO).
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