Inovalon’s 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

The Company’s Superior Quality Analytics SaaS Solution With Predictive Cut Point Forecasting and Medicare Benchmarking Enables Leading Health Plans to Outperform Their Peers

BOWIE, Md., Oct. 31, 2024 (GLOBE NEWSWIRE) — Inovalon, a leading provider of cloud-based software solutions empowering data-driven healthcare, today announced customer results for the 2025 Medicare Advantage Star Ratings. Released by the Centers for Medicare & Medicaid Services (CMS) this month, Inovalon’s customers realized a 5% increase above the national average, with four of the seven (57%) 5-star health plans using Inovalon’s Converged Quality solution—achieving the highest Medicare Advantage (MA) rating available.

While most health plans experienced ratings decline for the third year in a row, Inovalon’s customers realized a 5% increase over the national average. Today, customers leverage Inovalon’s Converged Quality software for quality reporting, including regulatory clinical measure rates, quality improvement activity reporting, predictive cut point forecasting, and Medicare benchmarking. Inovalon helps customers address quality measure gaps, contributing to their above-average performance, by providing timely insights into measurement performance throughout the year, analytically driven intervention planning and prioritization, and patient-specific intervention outreach informed by industry-leading subject matter expertise.

Inovalon’s customers outperformed the market for the Transitions of Care (TRC) measure with a 26.6% improvement from last year’s rating period. One of the most notable changes was on the Medication Adherence for Diabetes Medications (MAD) measure; while most MA contracts reported close to a 5% decrease in 2025, Inovalon customers performed better by 5% year-over-year.

“Health plans need a trusted vendor with extensive knowledge of CMS requirements to meet regulatory guidelines and receive rewards from the government—especially in an eventful year of Star Ratings recalculations and increased pressure on plans due to raised cut points and falling rating performance,” said Mike Jones, President and GM of the Payer business unit of Inovalon. “Inovalon has a proven history of helping health plans achieve exceptional Star Ratings performance, consistently demonstrating its value as a trusted partner for payers navigating the complex, and sometimes overwhelming, CMS landscape. This year’s results emphasize this further as more Medicare plans trust Inovalon to support their prospective reporting and forecasting strategy.”

The average Star Rating decreased from 4.07 in 2024 to 3.92 in 2025, and the percentage of MA plans with 4+ stars decreased from 32% in 2024 to 30% in 2025, which includes the total percentage of enrollees in 4+ Star MA-PD plans dropping from 75% to 61%. Much of this downward trend is attributed to CMS introducing a methodology change in the last rating period and recalculating the rating. Inovalon has been at the forefront of determining how these changes impact ratings and giving its customers an early look at the impacts; the company’s forecasted cut point analysis demonstrated more than 95% accuracy when compared with CMS-released cut points for the last three years.

Inovalon’s Converged Quality solution delivers the nation’s most widely used healthcare quality data analysis and improvement software, supporting more than 100 leading health plans representing nearly 193 million covered lives. By integrating, aggregating, and analyzing a growing volume of primary source healthcare datasets at high speed, Converged Quality supports measurement and improvements in clinical quality performance indicators. The software-as-a-service (SaaS) solution has been developed in native cloud-based architecture, allowing for extremely scalable, high-speed performance to empower even the most advanced health plan’s quality performance goals.

For more information on Inovalon’s Converged Quality platform and Star Ratings, visit our site: https://www.inovalon.com/products/payer-cloud/quality/.

About Inovalon

Inovalon is a leading provider of cloud-based SaaS 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 more than 53,000 sites of care, and are informed by the primary source data of more than 85 billion medical events across 1.1 million physicians, 677,000 clinical settings, and 395 million unique lives. For more information, visit www.inovalon.com.

Contact:
Tom Paolella
Sr. Director, Press and Analyst Relations, Inovalon
Thomas.Paolella@isnovalon.com