CUSTOMER STORY:
Seeing Stars: How LEON Health Achieved Consecutive 5-Star Ratings With Inovalon
LEON Health, a regional health plan serving 40,000 members in Miami-Dade County, Florida took a leap in 2022. After parting ways with their national partner, they stepped out on their own to offer Medicare Advantage (MA) and Dual-Eligible Special Needs Plans (D-SNPs).
They needed a quality reporting solution that could handle their first HEDIS® season, report accurate measures, and offer real human support, not just a login to a help center.
Enter Inovalon’s Converged Quality™. The result? LEON Health achieved two perfect CMS 5-star ratings, back-to-back.
Looking for a Partner, Not Just a Vendor
As a regional, agile plan, LEON Health goes the extra mile for its members. For example, they offer appointments with primary care providers and specialists within days instead of weeks. So, when it came time to choose a quality solution, they weren’t just ticking boxes – they needed a partner who shared their commitment to service.
“At the end of the year, if we don’t have the right medical record system and we don’t have the right regulatory reports to submit, we’re going to fail,” says Leslye Roque, Vice President of Quality Programs at LEON Health.
Roque says their HEDIS auditor highly recommended Inovalon and Converged Quality. For health plans, HEDIS measures are a critical, performance-based program that helps ensure accountability in providing quality care and enables comparisons between health plans’ performance. In addition to regulatory compliance, how well a plan scores can come with financial incentives. This made selecting the right solution mission-critical.
Now with Converged Quality, LEON Health has the clear analytics it needs to understand its quality of care – in detail beyond what’s required for regulatory reporting. This empowers them to meet quality measurement needs and continue providing the best level of care for all members.
“We depend on [Inovalon] to be able to do that for us,” Roque said.
Having Someone with You Every Step of the Way
HEDIS season can be a challenging time for health plans of all sizes, especially for teams doing it alone for the first time. Fortunately, whenever the team at LEON Health encountered an issue, they knew they could turn to Inovalon’s Customer Support team.
In 2025, a technical issue during a member upload led to a sudden drop in quality scores. Maria Luisa Valle, HEDIS Data Analyst at LEON Health, emailed Inovalon and received a quick response – on a Sunday. “They were there for us all the way,” Valle said. “They set up time to walk through everything, and we’re good now. We’re truly grateful.”
Over the last two HEDIS seasons, Valle and Roque have come to view Inovalon’s support team “part of our team.” Whenever LEON Health gets stuck, has a question about the solution, or needs help, having someone willing to lend a hand, rather than suggesting they find their answer in a resource center, is “priceless.”
“To know that every step of the way, if something happens, we can count on them, it’s so important,” Valle said.
”To know that every step of the way, if something happens, we can count on them, it’s so important.”
Maria Luisa ValleHEDIS Data Analyst at LEON Health
Standing on Top of the Podium, Not Once but Twice
Quality scores affect many important goals for health plans, including the plan’s ratings on the CMS Star Ratings System. In a competitive market like Miami-Dade County, having high scores can put a health plan like LEON Health far above the rest.
In 2023, they did just that by scoring a perfect 5-star plan rating – one of only 31 plans to earn this distinction.1 LEON Health followed it up by being one of only seven plans in the U.S. to achieve a 5-star rating in 2024.2
Valle attributes maintaining high scores to their commitment to providing the best possible experience and care to their members. With help from Inovalon and Converged Quality, she said that her team has “zero worries” about certifying measures and a huge burden has lifted from their shoulders when submitting star ratings.
5-star ratings
1 of 31 plans
nationwide
1 of 7 plans
nationwide
Gain Peace of Mind Around Your Quality Scores With Inovalon
See how much easier the “busy season” can be with expert support, real-time gap detection, and the confidence that your quality scores are in good hands. Contact us to see Converged Quality in action and gain peace of mind next HEDIS season.
1 “Inovalon Customers Achieve Higher Performance On CMS Medicare Advantage Health Plan Ratings,” Inovalon, October 30, 2023, https://www.inovalon.com/news/inovalon-customers-achieve-higher-performance-on-cms-medicare-advantage-health-plan-ratings/
2 “Inovalon’s Converged Quality Solution Customers Realized a 5% Increased in Star Ratings Score, Including Nearly 60% of All Medicare Health Plans Which Received CMS’ Highest 5-Star Rating,” Inovalon, October 31, 2024, https://www.inovalon.com/news/inovalons-converged-quality-solution-customers-realized-a-5-increase-in-star-ratings-score-including-nearly-60-of-all-medicare-health-plans-which-received-cms-highest-5-star-rating/
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
