Komodo Sets a New Industry Standard for Applying Real-World Data and Analytics to More Accurately Understand Patient Insurance Status at Both Regional and National Levels

Today, Komodo Health launches Komodo Patient Insurance™ (KPI), a first-of-its-kind data offering featuring in-depth insights into the insurance status of more than 200 million de-identified U.S. patient lives. With this news, Komodo introduces the most comprehensive resource to accurately identify a patient's pharmacy and medical insurance enrollment status, including primary and secondary payer details across channel, segment, payer and geography. Commercial, Market Access, Medical Affairs, and HEOR teams will use KPI to quickly unlock answers to common business questions around patient enrollment and payer mapping.

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Komodo Patient Insurance Delivers a Complete, Patient-Level View of Enrollment and Offers Insight Into How Payer Coverage Impacts Patient Utilization (Photo: Business Wire)

Companies such as MoonLake Immunotherapeutics already use KPI as a source of intelligence to support their payer-insight needs. For example, as new therapeutics enter the market, Life Sciences companies need to track the impact of payer changes to understand the dynamics of market competition, shifts in clinical practice and prescribing, and changes in patient access to cutting-edge treatments. A recent analysis by Komodo used KPI to investigate market-share trends for hematology-oncology treatments, revealing Medicare as the dominant payer across most prescriptions. From there, users can also use KPI to identify which segments and commercial payers manage these patients. Leveraging KPI’s detailed, real-time insights, organizations can refine market positioning, review utilization management activities to augment brand strategies, and tailor patient outreach to align with healthcare provider preferences and patient needs.

Traditionally, data aggregators have only offered payer information at the claims level, which lacks the comprehensive patient enrollment details necessary to accurately understand a patient’s insurance status. As a result, healthcare and Life Sciences companies have had to invest heavily across multiple, fragmented data sources and then manually stitch them together. This outdated approach is prone to bias and error, with limited visibility into true insurance status as well as the channels, segments, and payers impacting brand performance. In contrast, KPI unlocks the ability to holistically assess and accurately understand the full payer landscape.

In conjunction with Komodo’s Healthcare Map^TM, KPI helps accurately identify patients with dual Medicare and Medicaid eligibility to determine which payer entities are most relevant to promotional priorities, evaluate the impact of payer restrictions, and rank payers by disease, cohort, and brand performance. KPI combines detailed longitudinal insurance status information with Komodo’s best-in-class healthcare utilization information to deliver a more up-to-date view of payer impact. This allows for better tracking of medical and pharmacy policy criteria and payer coverage — in real time and across geographies — to inform and measure pull-through planning, contract effectiveness, and commercial and market landscape strategies for both new and existing therapies. Komodo leverages insights from payer-derived sources in combination with event data from the Healthcare Map to fill the gaps left by claims-based payer data alone and provides detailed, integrated insights on patient insurance status.

“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."

Customers can tap into KPI across several of Komodo’s technology and data solutions, including Sentinel, two new pre-built Payer Mapping and Payer Analytics dashboards in MapView, and as part of Komodo’s MapEnhance^TM offering. To learn more about how companies are using KPI to gain a more accurate and comprehensive understanding of a patient's insurance status, register for Komodo’s upcoming webinar on June 27.

About Komodo Health

Komodo Health is a technology platform company creating the new standard for real-world data and analytics by pairing the industry’s most complete view of patient encounters with enterprise software and machine learning that connects the dots between individual patient journeys and large-scale health outcomes. Across Life Sciences, payers, providers, and developers, Komodo helps its customers unearth patient-centric insights at scale — marrying clinical data with advanced algorithms and AI-powered software solutions to inform decision-making, close gaps in care, address disease burden, and help enterprises create a more cost-effective, value-driven healthcare system. For more information, visit Komodohealth.com.

Meta Description: Komodo Health launches Komodo Patient Insurance, the first comprehensive payer insights solution to help Life Sciences accurately identify a patient's pharmacy and medical insurance enrollment status.

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