Babel Health

Founded in 2014, Babel Health carved out a specific niche in the healthcare technology sector by focusing on the complexities of risk adjustment and encounter data submissions for government-sponsored healthcare plans. The company was co-founded by Oron J. Strauss and Mark Tobias. Strauss, who served as chairman, brought more than two decades of experience in managing growth-stage companies across various industries and holds bachelor's degrees from Dartmouth College.

Babel Health developed a software-as-a-service (SaaS) platform designed to streamline the entire risk adjustment submission process for health plans covering Medicare Advantage, Medicaid, and Affordable Care Act (ACA) markets. The company's business model centered on providing this integrated data management platform to health insurance companies, particularly small to medium-sized plans that might not afford a sophisticated in-house system. The platform functioned as an ETL (extract-transform-load) system that allowed clients to upload patient and encounter data. It would then validate this data for accuracy and compliance, checking for irregularities and formatting issues before submission to state and federal governments. This process gave health plans greater transparency and control over their data, helping them to improve submission accuracy, ensure regulatory compliance with acts like HIPAA, and optimize revenue. A key feature was its ability to manage both RAPS (Risk Adjustment Processing System) and EDPS (Encounter Data Processing System) submissions on a single platform, eliminating data duplication and simplifying workflows for clients like Highmark Health.

The company's growth was financed through several funding rounds, including a $6.5 million Series A round in 2019 led by Draper Triangle Ventures and a strategic healthcare investor. This capital was aimed at expanding its team and enhancing the platform's capabilities. In March 2022, Babel Health was acquired by Allscripts Healthcare for $24.5M and subsequently merged into its Veradigm business unit. Following the acquisition, the Babel Health platform was rebranded and integrated into Veradigm's offerings as 'Veradigm Comprehensive Submissions'.

Keywords: risk adjustment, encounter data submission, healthcare data management, SaaS, health plan compliance, RAPS, EDPS, Medicare Advantage, Medicaid, ACA, ETL healthcare, healthcare fintech, claims data validation, revenue cycle management, HIPAA compliance, Veradigm, Allscripts, Oron J. Strauss, Mark Tobias, government healthcare programs