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Inovalon Customers Achieve Higher Performance on CMS Medicare Advantage Health Plan Ratings

By: Inovalon Holdings, Inc. via GlobeNewswire

October 30, 2023 at 09:00 AM EDT

BOWIE, Md., Oct. 30, 2023 (GLOBE NEWSWIRE) -- Inovalon, a leading provider of cloud-based software solutions empowering data-driven healthcare, announced today that customers using its cloud-based Converged Quality solution for quality measurement, reporting, and improvement outperformed other health plans on the 2024 Medicare Advantage Star Ratings released by the Centers for Medicare & Medicaid Services (CMS) on October 13, 2023. Health plans using Inovalon’s Converged Quality solution with Managed Services realized an 8% average rating increase year over year – a significant achievement in a year when most plans saw their ratings fall.

Half of the 31 health plans that achieved the highest 5-Star rating use Inovalon’s software, as well as 47% of the total 198 4+-Star plans. Health plans that used Inovalon’s Converged Quality SaaS solution for more than two years achieved consistent improvements year over year. Inovalon helps customers address quality measure gaps, contributing to their above average performance, by providing timely insights into measurement performance throughout the year, analytically driven intervention planning and prioritization, and patient-specific intervention outreach informed by industry leading subject matter expertise.

Health plans supported by Inovalon’s services outperformed the market on key clinical and administrative measures, including an average rating that is: 13% higher than the market for Controlling High Blood Pressure (CBP); 19% higher for Medication Reconciliation Post-Discharge (MRP); 17% higher for Osteoporosis Management in Women Who Had a Fracture (OMW); and more than 5% higher on the triple-weighted Medication Adherence measures.

“Inovalon’s Converged Quality solution is at the core of the majority of health plans’ focus on clinical quality performance,” said Eron Kelly, President of Inovalon. “Even in a year where most plans saw decreases in their performance on the Medicare Star ratings, Inovalon customers achieved better performance.”

For 2024, the average Star rating decreased for many health plans across the nation due to changes in cut point methodology CMS introduced this ratings period, including introducing the Tukey statistical method used for identifying outliers. Inovalon has been at the forefront of identifying how recent changes impact ratings and giving its customers an early look at the impacts; the company’s forecasted cut point analysis demonstrated more than 95% accuracy when compared with CMS released cut points for the last three years.

Inovalon customer Network Health earned 5 Stars, the highest possible rating from CMS, for its Medicare Advantage PPO plans. “Every year, Medicare evaluates plans based on a 5-Star rating system and for 2024 and the third year in a row Network Health earned a 5 out of 5 overall Star rating for our Medicare Advantage PPO plans. This is Medicare’s highest possible rating, reflecting the extra steps Network Health takes to do what’s right for our members,” Network Health Vice President, Quality and Clinical Integration, Elizabeth Strachota Benz said. “With this rating, Network Health outranks the national average of 4 Stars. Every year the benchmarks become more difficult, and this year was no different.”

Inovalon’s cloud-based Converged Quality solution delivers the nation’s most widely used healthcare quality data analysis and improvement software, supporting more than 100 leading health plans representing nearly 193 million covered lives. By integrating, aggregating, and analyzing a growing volume of healthcare datasets at high speed, Converged Quality supports measurement and improvements in clinical quality performance indicators. The software-as-a-service (SaaS) solution has been developed in native cloud-based architecture, allowing for extremely scalable, high-speed compute performance to empower even the most advanced health plan’s quality performance goals.

To learn more, visit the Inovalon blog.

About Inovalon
Inovalon is a leading provider of cloud-based software solutions empowering data-driven healthcare. The Inovalon ONE^® Platform brings together national-scale connectivity, real-time primary source data access, and advanced analytics into a sophisticated cloud-based platform empowering improved outcomes and economics across the healthcare ecosystem. The company’s analytics and capabilities are used by more than 20,000 customers and are informed by the primary source data of more than 79 billion medical events across one million physicians, 654,000 clinical settings, and 375 million unique patients. For more information, visit www.inovalon.com.

Contact:
Nick Panayi
Chief Marketing Officer, Inovalon
Nick.Panayi@inovalon.com

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Inovalon Customers Achieve Higher Performance on CMS Medicare Advantage Health Plan Ratings

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