Inovalon Presents Research on Understanding and Predicting Five Star Quality Measure Rating Thresholds

Five Star Rating Analysis to be presented at Academy Health 2014 Annual Research Meeting

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Jun 09, 2014, 04:00 ET

BOWIE, Md., June 9, 2014 /PRNewswire/ -- Inovalon, Inc., a leading technology company providing advanced cloud-based analytics and data-driven solutions to the healthcare industry, will present results of a study "Predicting Future CMS Five Star Rating Thresholds: Analytical Insights from 2008-2014 Trend Data" at the Academy Health 2014 Annual Research Meeting June 8–10 in San Diego, California.

Each year, Centers for Medicare and Medicaid Services (CMS) revises the one-to-five star thresholds for each quality measure included in the Medicare Advantage Five Star Rating System by applying "relative distribution, clustering, and significance testing" to plan level data. The purpose of this study was to analyze CMS published star ratings data for 2008-2014 to investigate the link between the distribution of measure rates, the proportion of plans at each star level, and thresholds to gain insight into the rationale behind changes in thresholds over time. The analysis found that star thresholds changed (increased or decreased) for nearly every measure for each year, except for the 25 Part-C and 4 Part-D measures with pre-set four-star thresholds. According to the study's authors, this analysis provides new insights into the rationale behind threshold shifts and points to the need for a more transparent and predictable approach to awarding Stars that health plans can understand and strive toward.

"The Five Star Rating System for Medicare Advantage plans was developed to drive quality improvement through public reporting and consumer choice, and also determine quality bonus payments," said Christie Teigland, PhD, Director of Statistical Research at Inovalon. "The goal of this research was to better understand and predict future star rating thresholds to allow plans to better target goals to improve their performance and star ratings. It is difficult to improve with ever changing and unpredictable targets. This analysis provides new insights into the rationale behind threshold shifts and points to the need for a more transparent and predictable approach to awarding stars that health plans can understand and strive toward."

Inovalon's Statistical Research Team co-authors include: Sandhya Mehta, PhD; Zulkarnain Pulungan, PhD; Barton T. Jones, MS; Alexis Parente, PhD and Christie Teigland, PhD.

About Inovalon, Inc.

Inovalon is a leading technology company that combines advanced cloud-based data analytics with highly targeted interventions to achieve meaningful impact in clinical and quality outcomes, utilization, and financial performance across the healthcare landscape. Inovalon's unique achievement of value is delivered through the effective progression of Turning Data into Insight, and Insight into Action^®. Large proprietary datasets, advanced integration technologies, sophisticated predictive analytics, and deep subject matter expertise deliver a seamless, end-to-end platform of technology and nationwide operations that bring the benefits of big data and large-scale analytics to the point of care. Driven by data, Inovalon uniquely identifies gaps in care, quality, data integrity, and financial performance – while also bringing to bear the unique capabilities to resolve them. Touching more than 540,000 physicians, 220,000 clinical facilities, and more than 140 million Americans, this differentiating combination provides a powerful solution suite that drives high-value impact, improving quality and economics for health plans, ACOs, hospitals, physicians, patients, and researchers. For more information visit www.inovalon.com.

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SOURCE Inovalon, Inc.