First SaaS Solution for Health Plans to Address Health Disparities and Fulfill CMS Health Equity Index Requirements
BOWIE, Md., Aug. 06, 2024 (GLOBE NEWSWIRE) -- Inovalon, a leading provider of cloud-based software solutions empowering data-driven healthcare, today launched Converged Stars Health Equity Analytics to help Medicare Advantage (MA) plans address healthcare disparities and improve performance in alignment with the new Centers for Medicare & Medicaid Services (CMS) Health Equity Index (HEI) framework. The SaaS solution enables MA health plans to predict CMS HEI scores and rewards, identify and address gaps in health equity programs, and benchmark performance against other plans. CMS is using performance data from 2024 and 2025 to calculate the HEI score and reward, making it essential for MA plans to gain insights into HEI performance now while they still have the opportunity to identify, understand, and address disparities.
The pandemic underscored systemic health disparities, prompting CMS to introduce the HEI as the new reward factor to incentivize MA and Part D plans to improve care quality for socially at-risk beneficiaries. CMS ranks contract quality measure performance for populations with social risk factors to determine additional rewards against the plan’s star ratings performance. While most plans have launched health equity initiatives, many lack the necessary data infrastructure to drive and sustain meaningful impacts for members and their bottom line.
Inovalon’s Converged Stars Health Equity Analytics provides actionable insights based on CMS’ 14 individual quality measures, stratified by social risk factors such as dual eligibility for Medicaid, low-income subsidy, disabled status, and more. The solution tracks performance and enrollment at the patient, contract, and plan levels to focus on areas with significant disparity gaps and tailor solutions to address member characteristics and needs. Inovalon’s data visualizations and analytics empower MA plans to target efforts effectively, continually analyze progress, and improve member outcomes and star ratings for bonus payments.
“As many health inequities are systemic, addressing disparities at the population health level requires detailed analyses,” said Mike Jones, President and General Manager of Inovalon’s Payer Business Unit. “Converged Stars Health Equity Analytics meets this need by empowering health plans with essential insights into their performance metrics for their populations with social needs and the factors impacting their CMS Health Equity Index reward. Our customers benefit from seamless access to not only meaningful analyses of their own membership situation, but also reliable benchmarking data and insights that support broader quality and risk initiatives, which are crucial to advancing health equity.”
Converged Stars Health Equity Analytics, part of Inovalon’s Converged Solution Suite, is the only SaaS solution that offers real-time analyses of a MA plan as well as comparative analyses of its performance against other contracts to determine CMS HEI scores and reward factors. The suite allows current and prospective health plan customers immediate cloud access to meet HEI reporting requirements and pathways to improvement when needed.
These insights are powered by Inovalon’s analytics engine that leverages data from its MORE2 Registry®, the largest healthcare primary source and de-identified dataset on over 391 million unique lives and quality metrics from more than 80% of U.S. health plans’ members. The Registry covers more than 50% of Medicare beneficiaries and delivers benchmark data for Converged solutions to optimize quality measurement, star ratings, risk adjustment, and more.
To learn more about how Converged Stars Health Equity Analytics can forecast performance and help your plan meet the CMS HEI requirements, please visit: https://www.inovalon.com/products/payer-cloud/stars-health-equity-analytics/.
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 nearly 20,000 customers supporting over 53,000 sites of care, and are informed by the primary source data of more than 84 billion medical events across 1.1 million physicians, 670,000 clinical settings, and 391 million unique lives. For more information, visit www.inovalon.com.
Contact:
Tom Paolella
Sr. Director, Press and Analyst Relations, Inovalon
Thomas.Paolella@inovalon.com
