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PAYER CLOUD

Quality Improvement Solutions

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Measuring quality and improving care

Achieving and maintaining high performance on CMS star ratings is a constant moving target for Medicare Advantage (MA) plans. Supported by Inovalon’s comprehensive suite of software and analytics solutions, Converged Quality customers have realized an 5% average star rating increase year over year (YoY).1 Inovalon’s forecasted cut point analysis demonstrated more than 95% accuracy compared to CMS-released cut points for the last three years.1

Discover the capabilities relied on by half of all 5-star rated MA plans:

  • Stars Forecast Insights
  • Converged Analytics Benchmarking
  • Medication Adherence Measures Analysis
  • Converged Stars Health Outcomes
  • Quality Improvement Predictive Analytics

Inovalon Supports Top‑Scoring Health Plans

A circular chart highlights that 57% of 5-star plans are represented, with the rest in a lighter shade—showcasing the impact of quality improvement solutions. The center displays: 57% of 5-Star plans.

Converged Quality
Customers Experience:

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5%

avg. rating increase YoY1

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95%

forecasted cut point accuracy1

Converged Quality Improvement Solutions

Quality products, services, and features for improving MA Star Ratings.

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Stars Forecast Insights

Accurately forecast CMS cut points to measure current performance and predict future star ratings performance. This capability helps health plans clearly identify areas at risk of poor performance.

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Converged Analytics Benchmarking

Gain greater insight into how industry performance for quality measures is trending for the current year with monthly reports to empower a proactive quality measurement approach.

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Medication Adherence Measures Analysis

Support the triple-weighted CMS Medication Adherence measures with software that examines individuals’ prescription claims for specific classes of medication therapy.

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Converged Stars Health Outcomes

Ensure readiness for the Excellent Health Outcomes for All by forecasting potential score and reward. View your health plan’s rankings compared to the competition and understand how each measure impacts EHO4all score.

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Quality Improvement Predictive Analytics

Enable early detection of quality measure eligibility to drive more timely interventions.

1 “2025 CMS Star Ratings results: Inovalon’s customers shine bright among falling
stars,” Nov. 8. 2024, https://www.inovalon.com/blog/2025-cms-star-ratings-results-inovalons-customers-shine-bright-among-falling-stars

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