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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Allina to pull medical residents out of United Family Medicine clinic on St. Paul’s West Seventh



(Thinkstock)


© Provided by Twin Cities Pioneer Press
(Thinkstock)

For 50 years, the United Family Medicine clinic on St. Paul’s West Seventh Street has catered to the working poor and underinsured patients, including today many East African immigrants and neighborhood residents.

And the nonprofit health center has done so hand-in-hand with Allina Health, a 12-hospital, 90-clinic health network that has provided the majority of the clinic’s physicians, 21 medical residents, electronic records, lab services and even their phone line.

Now, Allina is in the process of pulling out all 21 medical residents and finding another location near United Hospital where the medical residents can complete their three-year rotations in family medicine.

By the end of the year, the faculty physicians are expected to follow them, leaving the clinic nearly devoid of primary care doctors. Physician assistants and nurse practitioners are expected to pick up the slack under the clinic’s new model of team-based care.

“The pandemic certainly has accelerated changes in the health care system,” said Sara Criger, president of United Hospital, who said medical residents and faculty had complained of patient scheduling and other issues at the clinic, hurting the reputation of Allina’s residency program.

Criger added: “There were problems that United Family Medicine needed to address. As the clinic made changes, we had to determine if they meet our requirements or not, and it became apparent that they did not.”

The deteriorating relationship between the community health clinic and Allina has led to finger-pointing on at least three sides.

CALLS FOR CEO TO RESIGN

Alarmed by a lengthy period of employee furloughs and other emergency management steps, a group of former United Family Medicine board members and West Seventh Street advocates have laid blame on the health clinic’s leadership and called for them to step down.

Those advocates include former United Family Medicine board chair Andrea Marboe, longtime West Seventh Street activist Marit Brock and former St. Paul City Council Member Dave Thune.

“We’ve totally lost confidence in the program and they should stop funding them,” said Thune, who is circulating a petition calling for major funders to sever ties and for United Family Medicine Chief Executive Officer Ann Nyakundi to resign.

“We want a neighborhood clinic with doctor-patient relationships, real family physicians that follow you to the hospital,” Thune said. “She walked in and six months later turned the clinic upside down. We just prefer she leave now.”

Nyakundi and Jonathan Watson, CEO of the Minnesota Association of Community Health Centers, said operations at the clinic have stabilized since the start of the pandemic.

“When I inherited the clinic, our 2020 budget at the start of the year was actually worse than it is now,” said Nayakundi, who stepped in as CEO last October after the previous CEO resigned. “We’ve done a really good job efficiently navigating the pandemic and staffing to demand. We temporarily had furloughs, but we’ve brought all of the staff back, and we’re actually in a period of growth.”

Critics, including former board

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Allina to pull medical residents out of United Family Medicine clinics on St. Paul’s West Seventh



(Thinkstock)


© Provided by Twin Cities Pioneer Press
(Thinkstock)

For 50 years, the United Family Medicine clinic on St. Paul’s West Seventh Street has catered to the working poor and underinsured patients, including today many East African immigrants and residents.

And the nonprofit health center has done so hand-in-hand with Allina Health, a 12-hospital, 90-clinic health network that has provided the majority of the clinic’s physicians, 21 medical residents, electronic records, lab services and even their phone line.

Now, Allina is in the process of pulling out all 21 medical residents and finding another location near United Hospital where the students can complete their three-year rotations in family medicine.

By the end of the year, the faculty physicians are expected to follow them, leaving the clinic nearly devoid of primary care doctors. Physician assistants and nurse practitioners are expected to pick up the slack in the clinic’s new team-based care model.

“The pandemic certainly has accelerated changes in the healthcare system,” said Sara Criger, president of United Hospital, who said medical residents and faculty had complained of patient scheduling and other issues at the clinic, hurting the reputation of Allina’s residency program.

Criger added: “There were problems that United Family Medicine needed to address. As the clinic made changes, we had to determine if they meet our requirements or not, and it became apparent that they did not.”

The deteriorating relationship between the community health clinic and Allina has led to finger-pointing on at least three sides.

CALLS FOR CEO TO RESIGN

Alarmed by a lengthy period of employee furloughs and other emergency management steps, a group of former United Family Medicine board members and West Seventh Street advocates have laid blame on the health clinic’s leadership and called for them to step down.

Those advocates include former United Family Medicine board chair Andrea Marboe, longtime West Seventh Street activist Marit Brock, former St. Paul City Council Member Dave Thune and St. Paul Public Works Director Sean Kershaw, who was recently a nonprofit leader.

“We’ve totally lost confidence in the program and they should stop funding them,” said Thune, who is circulating a petition calling for major funders to sever ties and for United Family Medicine Chief Executive Officer Ann Nyakundi to resign.

“We want a neighborhood clinic with doctor-patient relationships, real family physicians that follow you to the hospital,” Thune said. “She walked in and six months later turned the clinic upside down. We just prefer she leave now.”

Nyakundi and Jonathan Watson, CEO of the Minnesota Association of Community Health Centers, said operations at the clinic have stabilized since the start of the pandemic.

“When I inherited the clinic, our 2020 budget at the start of the year was actually worse than it is now,” said Nayakundi, who stepped in as CEO last October after the previous CEO resigned. “We’ve done a really good job efficiently navigating the pandemic and staffing to demand. We temporarily had furloughs, but we’ve brought all of the staff back, and we’re actually

Read more