Inovalon Clients Outperform Market for CMS Star Ratings for the Seventh Year in a Row

The Inovalon ONE® Platform Supports Meaningful Quality Outcomes Improvements and Value Delivery

BOWIE, Md., Nov. 02, 2020 (GLOBE NEWSWIRE) — Inovalon (Nasdaq: INOV), a leading provider of cloud-based platforms empowering data-driven healthcare, today announced that clients utilizing Inovalon’s quality improvement solution suite outperformed the entire Medicare Advantage market for the seventh year in a row, realizing a positive increase of nearly 4% on a year-over-year basis in their Centers for Medicare & Medicaid Services (CMS) 2021 Star Ratings.

Inovalon’s clinical quality data aggregation, advanced analytics, integrated outreach, and data visualization toolsets provide health plans with targeted patient-level insights to improve quality of care and member health outcomes. Able to integrate, aggregate, and analyze the growing volume of healthcare datasets at high speed to support improvements in clinical quality outcomes measures, the Inovalon ONE® Platform delivers the nation’s most widely used healthcare quality data analysis and improvement platform, with more than 76% of U.S. reported lives running through the Inovalon Platform in 2020.

These results reflect data released by CMS on October 9, 2020, pertaining to all Medicare Advantage and Prescription Drug Plans, which revealed that on a year-over-year basis, Star Rating scores decreased by 2.17% for the average Medicare Advantage health plan on an enrollment-weighted basis. These results also reflect adjustments CMS made to minimize the impact of the ongoing COVID-19 pandemic, allowing plans to use the higher of their 2020 or 2021 CMS Star Ratings for approximately 50% of the measures. Despite the overall market decreasing by 2.17%, clients leveraging Inovalon’s quality improvement suite realized an average increase of 3.72% in their 2021 Star Ratings. The achievement of higher Star Ratings reflects the great work of Inovalon’s health plan clients and the ability of the Inovalon ONE® Platform to rapidly deliver actionable analytical insights, empowering superior care delivery by health plans to their millions of members, and create positive, measurable economic performance impact.

“Over the past year, the challenges created by the COVID-19 pandemic combined with the rapid changes to how and where care is delivered have accelerated the need to rely upon a technology platform capable of addressing patient-specific gaps in care within the Medicare Advantage population,” said Kris Volrath, Vice President at Inovalon. “We are pleased to support and empower the continued strong performance of our clients, reflecting their adoption of industry-leading technologies and data-driven insights to achieve meaningful impact during an unprecedented year.”

About the CMS Star Ratings Program

The national Star Ratings performance program, instituted by CMS, measures and reports on a wide range of clinical and quality outcomes pertaining to members and health plans across the United States. The quality measures addressed are utilized by federal and state programs to determine quality scoring and associated incentives and penalties for such programs as CMS’ Medicare Advantage Five-Star Quality Rating System, the U.S. Department of Health and Human Services’ (HHS) Quality Ratings System (QRS) for Affordable Care Act (ACA) plans, and state-based Managed Medicaid measurement programs. Inovalon’s solutions support these programs, as

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CMS imposed few penalties at nursing homes despite promises of tough enforcement

The federal agency and its state partners, Verma said, would conduct a series of newly strengthened inspections to ensure 15,400 Medicare-certified nursing homes were heeding long-standing regulations meant to prevent the spread of communicable diseases. It was another key component of a national effort, launched in early March, to shore up safety protocols for the country’s most fragile residents during an unprecedented health emergency .

But the government inspectors deployed by CMS during the first six months of the crisis cleared nearly 8 in 10 nursing homes of any infection-control violations even as the deadliest pandemic to strike the United States in a century sickened and killed thousands, a Washington Post investigation found.

Those cleared included homes with mounting coronavirus outbreaks before or during the inspections, as well as those that saw cases and deaths spiral upward after inspectors reported no violations had been found, in some cases multiple times. All told, homes that received a clean bill of health earlier this year had about 290,000 coronavirus cases and 43,000 deaths among residents and staff, state and federal data shows.

That death toll constitutes roughly two-thirds of all covid-19 fatalities linked to nursing homes from March through August.

Patient watchdog groups acknowledge that not every outbreak could have been prevented, even with adequate infection-control practices in place. But as the pandemic raged, the number of homes flagged for infection-control violations remained about the same as last year.

The facilities that were cited for breakdowns often escaped significant penalties, The Post also found.

Inspectors reported violations at about 3,500 homes, ranging from dirty medical equipment to a lack of social distancing. Though federal law allows CMS to levy fines of roughly $22,000 for each day a serious violation lingers, most providers were fined little or nothing at all.

For failing to ensure staff members wore masks, Sterling Place in Baton Rouge, with more than 80 coronavirus cases and 15 deaths, was fined $3,250.

For failing to separate residents in a common area, Heritage Hall in Leesburg, Va., with more than 100 cases and about 18 deaths, was fined $5,000.

For failing to use protective gear, the Broomall Rehabilitation and Nursing Center in Pennsylvania, with more than 200 cases and about 50 deaths — among the highest nursing home death counts in the country — was fined $9,750.

Broomall spokesperson Annaliese Impink attributed the lapses to “covid fatigue” and said staff members are corrected when concerns crop up. Officials with Sterling Place and Heritage Hall did not return calls seeking comment. In its written response to the inspection, Heritage Hall said tables had been rearranged and a nursing supervisor would monitor for compliance. Heritage Hall went on to suffer a second deadly outbreak last month, state records show.

The inspections follow a three-year push at CMS to ease rules long considered burdensome to the nursing home industry, whose lobbyists and leaders include former politicians and government insiders. Even before the coronavirus crisis, the agency took steps to limit the use of some

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