Komodo Health Unveils Integrated Patient Insurance Dataset for Life Sciences

What You Should Know: 

Komodo Health, a provider of real-world healthcare data and analytics, today announced the launch of Komodo Patient Insurance™ (KPI). 

– The new offering delivers the most comprehensive view of patient insurance status available, encompassing over 200 million de-identified U.S. patient lives.

KPI: Unprecedented Depth and Accuracy

KPI surpasses traditional solutions by providing in-depth insights into a patient’s pharmacy and medical insurance enrollment status, including details on primary and secondary payers across various channels, segments, payers, and geographical locations. This empowers healthcare and life sciences companies with the critical data needed to answer key business questions surrounding patient enrollment and payer mapping.

KPI in Action: Supporting Market Access Strategies

Companies like MoonLake Immunotherapeutics are already leveraging KPI’s intelligence to gain valuable payer insights. For instance, as new treatments enter the market, life sciences organizations require data to track the impact of payer decisions. This includes understanding market competition, shifts in prescribing patterns, and changes in patient access to innovative therapies. A recent Komodo analysis, powered by KPI, revealed Medicare as the dominant payer for hematology-oncology treatments across most prescriptions. KPI users can then leverage this data to identify patient segments and commercial payers managing these patients. Armed with KPI’s real-time insights, organizations can refine their market positioning, optimize brand strategies based on utilization management activities, and tailor patient outreach programs to align with healthcare provider preferences and patient needs.

Revolutionizing Payer Insights: Beyond Claims Data

Traditionally, data aggregators have provided payer information solely at the claims level, lacking the comprehensive patient enrollment details crucial for understanding a patient’s true insurance status. This forced companies to invest heavily in fragmented data sources, requiring manual integration – a time-consuming and error-prone approach. Such methods also limited visibility into true insurance status and the factors impacting brand performance, such as channels, segments, and payers. In contrast, KPI unlocks the potential for a holistic and accurate assessment of the entire payer landscape.

A Powerful Synergy: KPI and Komodo’s Healthcare Map

When used in conjunction with Komodo’s Healthcare Map™, KPI enables precise identification of patients with dual Medicare and Medicaid eligibility. This empowers organizations to prioritize promotional activities based on relevant payer entities, measure the impact of payer restrictions, and rank payers by disease, cohort, and brand performance.

A Real-Time View of Payer Dynamics

KPI offers a unique advantage by combining detailed longitudinal insurance status information with Komodo’s industry-leading healthcare utilization data. This combined view allows for real-time tracking of medical and pharmacy policy criteria and payer coverage across geographical regions. This comprehensive data informs and measures strategies across the commercial and market landscapes, including pull-through planning, contract effectiveness, and both new and existing therapy strategies. Komodo leverages insights from payer-derived sources alongside event data from the Healthcare Map to fill the gaps left by traditional claims-based payer data, delivering unparalleled, integrated insights into patient insurance status.

KPI: Integrated Solutions for Streamlined Access

Customers can access KPI through various Komodo technology and data solutions, including Sentinel, pre-built Payer Mapping and Payer Analytics dashboards within MapView, and as part of Komodo’s MapEnhance™ offering.

“Komodo Patient Insurance is the first comprehensive payer insights solution, helping the industry look beyond the events within a patient record to focus on the individual patient instead of their medical claims,” said Web Sun, President and Co-Founder, Komodo Health. “Komodo has always been at the forefront in delivering the highest-fidelity, granular, patient-centric intelligence needed to drive business decision-making. With KPI, we’re empowering Life Sciences to uncover key commercialization insights, enhancing their ability to assess payer impact and make informed market access decisions.”