WellSense Health Plan is a nonprofit health insurance provider serving more than 700,000 members across Massachusetts and New Hampshire. Offering Medicare, Individual and Family, and Medicaid plans, WellSense has spent more than 25 years committed to delivering high-quality, accessible coverage for individuals across a wide range of circumstances. Their mission is centered on supporting member health, satisfaction, and equity – priorities that guide both their strategy and their partnerships.

For more than a decade, Danny Sharpe, Senior Director of Quality Analytics at WellSense, has relied on Inovalon as a core partner in achieving strong quality performance. Over 14 years Sharpe has consistently chosen Inovalon because of one thing above all else: trust.

“Inovalon is consistent,” he shared. “We have to pass audits – that’s one of my biggest priorities: that we don’t have any issues with passing our audits. I know Inovalon consistently gives me correct numbers, all the time, year after year.”

For WellSense, accuracy and reliability aren’t just operational needs, they directly impact the funding the plan receives from state and federal programs. With millions of dollars tied to quality results, consistent data matters. And according to Sharpe, Inovalon has delivered that reliability every single year.

For Sharpe and the WellSense team, the longevity of the partnership isn’t just about technology, it’s about the relationship. “We’re more like partners with everybody at Inovalon. I’m not just a customer; we work on things together,” he shared. “It’s the trust. We all trust each other and we’re honest with each other.”

WellSense’s quality strategy relies heavily on rapid, accurate data and the ability to act on it. With Inovalon’s solutions, the team can access updated information in as little as four days, enabling immediate provider and member outreach.

“A lot of the value is working with our providers. I can get provider scorecards out instantly. The data is not two weeks old,” Sharpe explained. “Having that data quickly at hand saves a lot of time, and when we reach out, it results in a lot less abrasion with our providers and members.”

Another example is Inovalon’s  Electronic Record on Demand ^TM,  which WellSense recently deployed and is already seeing measurable value from. According to Sharpe, the solution has delivered roughly a 10% lift on key measures, including emergency department utilization. These gains translate directly into higher incentive payments and reduced withholds from state programs.

“It gives us higher rates, which then brings in more money from the government and the states… If we have more money, we can give our members more benefits and make them happier,” Sharpe shared, “That’s what we strive for.”

As the industry prepares for (DQM) and HL7® FHIR®-formatted data exchange, WellSense is already planning its transition, and expects Inovalon to be central to that effort.

“Digital quality measures are coming soon. It’s all new to me, it’s all going to be new to my company. Inovalon is going to be a big part of that,” Sharpe said.