Clinically Validated Behavioral Chronic Disease Management That Bends the Cost Trend
Abacus Health Solutions is a pioneer in behaviorally focused chronic disease management — founded by researchers and clinicians from Brown University's Warren Alpert Medical School and built on more than 35 years of independently validated outcomes data. Through AP3, Abacus delivers precision-targeted intervention for the high-risk members driving a disproportionate share of employer health plan spend.
The Challenge
The Healthcare Employer Chronic Disease Management Challenge
Chronic conditions represent the single largest driver of employer health plan costs — and the gap between clinical guidelines and actual member behavior is where most of that cost lives. Healthcare organizations face compounding challenges managing their own employee populations.
Diabetes and Obesity Drive Disproportionate Cost
Members diagnosed with diabetes and/or obesity account for a disproportionate share of inpatient hospitalizations, medical claims, and long-term cost volatility that compounds year over year.
Standard Disease Management Programs Fail to Engage
Standard disease management programs fail to engage high-risk members at meaningful participation rates — averaging 4–5% nationally, leaving the majority of at-risk employees and dependents without structured support.
Medication Non-Adherence Drives Avoidable Hospitalizations
Non-adherence to chronic condition medications is a primary driver of avoidable hospitalizations and emergency care utilization — and most programs lack the behavioral infrastructure to address it systematically.
Care Gaps Accumulate Silently
Missed labs, skipped provider visits, and deferred screenings accumulate without intervention until a high-cost claim event occurs — at which point the opportunity for prevention has passed.
Generic Wellness Programs Address Experience, Not Economics
Digital-only offerings and general wellness platforms are not designed to manage clinical risk at the population level. They address employee experience — not health plan economics.
No Claims-Based Analytics to Identify Risk Early
Most employers lack the claims-based analytics infrastructure to identify which members are at highest risk of hospitalization before the event occurs — making proactive intervention impossible.
The Abacus Health AP3 Solution
A Precision-Targeted Behavioral Chronic Disease Management Platform
Abacus Health Solutions delivers a comprehensive, data-driven chronic disease management platform built to identify, engage, and support the highest-risk members in any self-funded employer health plan — with independently validated outcomes documented across more than seventeen years of real-world employer data.
Proprietary Risk Stratification & Precision Targeting
A proprietary risk algorithm mines medical and pharmacy claims data from national and regional health plans and PBMs to build a precision engagement profile for every potential program participant — recruiting members based on actual clinical risk, not demographic averages.
Diabetes Care Reward Program
An independently validated, data-driven intervention that closes ADA gaps in care by driving members to providers, improving medication adherence, and supporting evidence-based clinical protocols. Patented behavior-contingent incentives deliver $0 copay waivers on covered diabetes medications and supplies in real time based on program adherence.
Documented Diabetes Outcomes
20.1% decrease in members with an A1c greater than 9, 32% reduction in hospital admissions, 24% reduction in hospital days, and reduced frequency of high-cost claims among program participants — independently validated and peer-reviewed.
Healthy Weight / GLP-1 Program
An obesity management solution combining high-risk member recruitment, personalized care planning focused on sustainable maintenance, and medication prescribing by a primary care provider. Time-limited GLP-1 access (maximum 12 fills) as part of a 24-month intervention with broad clinical support and behavioral science expertise.
Documented Weight Loss Outcomes
Program participants lose 20% of body weight in the first twelve months while on GLP-1 medication and maintain 20% body weight loss at 24 months — twelve months after discontinuing medication — distinguishing this model from standard GLP-1 programs with no maintenance infrastructure.
Population Health Analytics & Reporting
Comprehensive analytics and outcomes reporting to demonstrate measurable ROI — including participation tracking, care gap closure data, hospitalization reduction metrics, and medical cost trend analysis available to plan sponsors throughout the program.
Is This Right for Your Organization?
Strong Alignment With Healthcare Organizations That:
The Abacus Health AP3 solution is purpose-built for self-funded healthcare employers experiencing rising stop loss premiums, catastrophic claim events, or chronic disease prevalence that standard wellness and disease management programs are failing to address.
Self-funded and experiencing rising stop loss premiums
Stop loss premiums or catastrophic claim events have increased in the past two renewal cycles, with chronic conditions — particularly diabetes or obesity — as identifiable drivers.
Operating disease management programs with low participation
Current wellness or disease management programs are not reaching high-risk members at meaningful rates, leaving the majority of the at-risk population without structured clinical support.
Lacking claims-based risk stratification analytics
There is no current mechanism to identify which members are at highest risk of hospitalization before a cost event occurs — intervention is reactive rather than proactive.
Seeing medication non-adherence drive claims
High-cost claims are traceable to members with chronic conditions who are not adhering to evidence-based medication protocols — a gap that standard programs are not structured to close.
Looking for an evidence-based partner with documented outcomes
Leadership needs a chronic disease management partner with independently validated, peer-reviewed outcomes data — not a general wellness platform making unsubstantiated ROI claims.
Seeking a differentiated GLP-1 management model
Current GLP-1 benefit access lacks a structured maintenance model — resulting in weight regain after medication discontinuation and no long-term clinical or financial return on pharmacy spend.
Why Through AP3
The AP3 Advantage
As a vetted Strategic Partner within the ASHHRA Preferred Partner Program, Abacus Health Solutions' engagement is structured to deliver more than a standard vendor relationship.
Formal Vetting & Governance
Abacus Health Solutions' capabilities and healthcare alignment have been formally evaluated through AP3's structured governance process.
Executive-Level Coordination
Engagements are coordinated through AP3 to ensure strategic alignment and executive-level transparency from the outset.
Pre-Negotiated Commercial Terms
Special pricing considerations and partner incentives are available exclusively through AP3 — not through direct outreach.
Integrated Ecosystem Alignment
Abacus Health Solutions connects to AP3's broader population health and stop loss strategy through Lockton — addressing chronic disease at the member level before it becomes catastrophic claim exposure at the plan level.
Request a Structured Evaluation
Start the Conversation
Complete the form and an AP3 representative will connect you with Abacus Health Solutions to discuss your chronic disease management and population health challenges. Engagements are coordinated through AP3 to ensure alignment and access to pre-negotiated terms.
