Opera Solutions Wins CMS Health Insurance Marketplace Contract to Support the Affordable Care Act

The Centers for Medicare & Medicaid Services chooses Opera Solutions for operational analytics.

Nov 17, 2015, 08:00 ET from Opera Solutions, LLC

JERSEY CITY, N.J., Nov. 17, 2015 /PRNewswire/ -- After three successful years working with the Centers for Medicare & Medicaid Services (CMS), Opera Solutions, a leading global Big Data platform company, today announced that CMS has chosen Opera Solutions for a three-year engagement. The $28 million contract will enable Opera Solutions to provide operational analytics for the Health Insurance Marketplaces under the Patient Protection and Affordable Care Act (ACA).

Opera Solutions' operational analytics will support a wide variety of CMS initiatives and priorities, ensuring data integrity and accuracy across its enrollment and payment processes. The company will also evaluate issuers' claims, revenue, and profit to help CMS make appropriate decisions in regard to the three risk-sharing programs of health insurance (or "3 Rs") — Risk Adjustment, Reinsurance, and Risk Corridors. Advanced analytics are required to ensure that issuers, states, and other entities regulated by CMS comply with the law. Opera Solutions will provide these analytical capabilities and ensure that other critical operations are coordinated and functioning properly.

"Big Data and advanced analytics are improving healthcare beyond clinical decision support. They are improving operational efficiency and ensuring claim accuracy," said Pieter Schouten, EVP of Healthcare at Opera Solutions. "CMS and Opera Solutions have been doing critical and groundbreaking work in operations by applying Opera Solutions' data analytics capabilities and domain expertise to a massive amount of ACA data."   

Signed into law on March 23rd, 2010, and opened for public enrollment on October 1st, 2013, the ACA has provided millions of people with access to health insurance. Opera Solutions played a critical role in helping CMS prepare for the ACA rollout in 2013, architecting and building transactional data systems and establishing a system for verifying and matching enrollment data with insurance company records, which helped CMS generate accurate tax information for Heathcare.gov enrollees. The company will continue its work with CMS by maintaining data integrity and laying the groundwork for more advanced analytics, which Opera Solutions has developed from more than 10 years of providing Big Data solutions to healthcare and other industries.

"We are honored to continue this important role of serving our country and playing a part in providing healthcare coverage to so many," said Opera Solutions Founder and CEO Arnab Gupta. "Opera Solutions has the Big Data platform, data science and domain expertise, and proven track record to ensure fluid operations and a positive experience for the federal government, state governments, insurance companies, and the insured population alike."

About Opera Solutions, LLC
Opera Solutions is a global provider of advanced analytics software solutions that address the persistent problem of scaling Big Data analytics. Signal Hub, the company's flagship technology platform, extracts and applies insights from the most complex data environments to address multiple business problems and opportunities, accelerating targeted business actions and radically reducing time-to-value.

Opera Solutions serves some of the world's most respected businesses in the financial services, healthcare, travel, hospitality, retail, and telecommunications industries, as well as key government entities. The Signal Hub platform touches hundreds of millions of consumers across many leading companies, with a specific focus on dramatically increasing revenue from existing customers while introducing new capabilities that drive competitive advantage. 

The key innovation behind Signal Hub is its ability to deliver data science at scale. The end-to-end platform automatically creates Signals, which can be shared, reused, and applied to multiple use cases throughout the enterprise. Machine learning technologies keep the Signals relevant, fresh, and accurate. This approach eliminates redundancies and the need to return to the raw data for each use case, resulting in a significant improvement in productivity. In this way, Signal Hub's proprietary technology enables enterprises to overcome what has become the primary obstacle to large-scale adoption of advanced analytics: solving the scalability challenge.

Opera Solutions has offices in North America, Europe, and Asia. For more information, visit www.operasolutions.com.

SOURCE Opera Solutions, LLC