Blue Cross and Blue Shield of Minnesota Selects Inovalon's Star Advantage™ Solution to Focus on Quality Outcomes

Leading Minnesota Health Plan Expands Strong Partnership to Include Multiple New Services

Aug 22, 2012, 08:00 ET from Inovalon, Inc.

BOWIE, Md., Aug. 22, 2012 /PRNewswire/ -- Inovalon, Inc. (the new name of MedAssurant, Inc.), a leading provider of data-driven healthcare solutions, today announced that Blue Cross and Blue Shield of Minnesota (Blue Cross), the largest health plan in Minnesota, has renewed and expanded its partnership with Inovalon with a multi-year engagement extending its existing partnership and implementing new solutions focused on achieving improved quality outcomes and advanced healthcare data insight within its Medicare Advantage and commercial memberships.

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The integrated suite provides Blue Cross with a broad set of capabilities to drive informed initiatives to improve quality, care, efficiency, and insight within both its expanding Medicare Advantage and commercial beneficiary membership. The data-driven suite leverages predictive analytics informed by more than 5.4 billion medical events within Inovalon's Medical Outcomes Research for Effectiveness and Economics Registry (MORE2 Registry®) to deliver insight into beneficiary and medical provider adherence to guideline-driven care, methods of improvement, and nuances of intervention that enable meaningful results. Inovalon's solutions provide end-to-end implementation capabilities to execute in partnership with Blue Cross the interventions needed to realize the goals of industry-leading quality, utilization, and financial efficiency – in a fully coordinated platform.

"We have been impressed by the degree to which Blue Cross and Blue Shield of Minnesota is committed to providing its members with the highest level of service and quality care while also focusing on the efficiency and effectiveness of programs," said Keith Dunleavy, M.D., President and Chief Executive Officer of Inovalon. "We are pleased to further build upon our partnership in Minnesota, while continuing to improve quality and financial outcomes through a broad array of data-driven solutions."

"At Blue Cross and Blue Shield of Minnesota, we are highly dedicated to delivering high-quality, cost-effective care to our members," said Frank Fernandez, Vice President of Government Programs of Blue Cross and Blue Shield of Minnesota. "We look forward to continuing our work with Inovalon to implement innovative programs and comprehensive services that help achieve these goals."

The Inovalon and Blue Cross relationship dates back to 2004 when Inovalon began providing quality measurement solutions for the Blue Cross Commercial and Medicare Advantage lines of business. Over subsequent years, Blue Cross MN has implemented Inovalon's HEDIS Advantage, Capitation Risk Adjustment (CARA®), Claims Aggregation, Analysis, and Submission (CAAS), and Encounter Data Processing (eCAAS Advantage) solutions. With the newly implemented enterprise agreement, Inovalon will expand its Prospective Advantage® solution to an extended Blue Cross population and add comprehensive Star Advantage and INDICES business intelligence solutions in a highly integrated platform.

About the Solutions

  • Star Advantage enables health plans to both better understand and meaningfully improve their CMS 5-Star Quality Ratings by leveraging the nation's most widely used healthcare quality measurement system, large-scale healthcare dataset analytics, and a nationwide clinical operations infrastructure designed to provide deep, dynamically updated insight into clinical quality outcomes and highly sophisticated gap closure capabilities – end-to-end. Informed by Inovalon's Medical Outcomes for Research on Economics and Effectiveness (MORE2 Registry®) which contains more than 5.4 billion medical events from more than 78 million unique de-identified individuals, Star Advantage gives health plans near-real-time insight needed to identify highly specific opportunities for quality improvement; derives detailed intervention planning for each specific member's needs, history, behavior and current situation; and then brings to bear highly targeted gap-closure operations using Inovalon's national and local clinical resources.

  • Prospective Advantage® combines advanced healthcare data analytics with coordinated patient and provider encounter facilitation and support to deliver an integrated solution for identifying and proactively closing gaps in quality, care, assessment, documentation, and risk score accuracy. Analytics bring meaningful intelligence to all forms of outreach and intervention – from print materials and call center outreach, to web-enabled decision support platforms and wireless tablets for In-Home member assessment optimization. Altogether, the highly data-driven approach achieves the right intervention for the right member, in the right venue, at the right time, facilitating the realization of highly efficient impact.

  • INDICES Reporting and Business Intelligence platform leverages OLAP cube technology and customized pre-calculated analytics to enable healthcare organizations near-real-time insight into member, provider, and clinical facility care, utilization, quality, disease, demographic, risk score and financial trends and performance. INDICES brings further value by providing comparative insight against over 78 million patients – enabling users to not only gain deep insight into their own performance with industry-leading detail, but also against highly relevant comparatives otherwise unmatched in the marketplace.

  • HEDIS Advantage is the nations' most widely used NCQA-certified administrative data analytics and coordinated hybrid medical record abstraction and reporting solution for CMS, NCQA, and state-specific quality programs and requirements. With the powerful technology of Quality Spectrum Insight™ (QSI), an NCQA-certified software, expert administrative data integration, and a nationwide network of registered nurses for medical record reviews, Inovalon has achieved perfect marks for successful implementations and no "Non-Report" audit findings. Supporting the data integration and analysis are dedicated project managers, each bringing experience as either a HEDIS auditor or as a HEDIS project manager at a health plan, and all having extensive understanding of the process, potential challenges, and proven solutions. 

  • CARA® is a retrospective risk adjustment solution providing a highly data-driven approach to the efficient identification, determination and substantiation of disease and comorbid condition data. Advanced analytics leverage insight gained from extensive clinical datasets of more than 5.4 billion medical events to identify potential gaps in disease and comorbidity data accuracy. A highly integrated platform designed to coordinate both EMR and paper-based medical record data aggregation thereafter facilitates a highly efficient process of "filling in the gaps" through the targeted abstraction of both discrete and non-discrete clinical data. This process results in a more thorough understanding of each member and a more comprehensive risk score value to ensure significant improvement in healthcare data, quality insight, and risk score accuracy.

  • CAAS aggregates, analyzes, reconciles and prepares submissions of risk adjustment data, performing the vast set of processes necessary to meet CMS risk adjustment processing system (RAPS) requirements. CAAS then provides the detailed reconciliations and management-level reporting health plans need to achieve timely reimbursement, forecast budgets, prepare bids and meet financial reporting requirements.

  • eCAAS Advantage provides a comprehensive claims processing and risk adjusted financial valuation solution to address CMS's transition from RAPS-based submissions to the new 5010-format encounter data submissions. eCAAS Advantage leverages industry-leading claims integrity and processing technologies to deliver an agile encounter solution that provides data integration, analysis and reporting. It offers Medicare Advantage organizations a solution for all types of claims and provides the flexibility to manage all encounter files and data in a single application and database, while meeting CMS-mandated compliance requirements. eCAAS Advantage has been certified by CMS for Encounter Data Front-End Testing.

About Blue Cross and Blue Shield of Minnesota

Blue Cross and Blue Shield of Minnesota, with headquarters in the St. Paul suburb of Eagan, was chartered in 1933 as Minnesota's first health plan and continues to carry out its charter mission today as a health company: to promote a wider, more economical and timely availability of health services for the people of Minnesota. Blue Cross is a not-for-profit, taxable organization. Blue Cross and Blue Shield of Minnesota is an independent licensee of the Blue Cross and Blue Shield Association, headquartered in Chicago. Go to to learn more about Blue Cross and Blue Shield of Minnesota.

About Inovalon, Inc.

Inovalon, Inc., the new name of MedAssurant, Inc., is a leading technology-enabled healthcare solutions provider focused on the importance of healthcare data and its ability to drive dramatic, objective improvement in clinical and quality outcomes, care management and financial performance throughout the healthcare community. Proprietary healthcare datasets, aggregation and analysis capabilities, combined with a national infrastructure of leading-edge technology, clinical prowess and deep human resources, empower Inovalon's advanced generation of healthcare assessment and improvement through highly informed solutions. Driven by a mission to improve today's healthcare landscape, the employees of Inovalon proudly apply care, ingenuity and dedication to delivering a new approach to healthcare touching nearly 120 million Americans – one driven by data and insight – one resulting in meaningful action. Please visit for more information. 

SOURCE Inovalon, Inc.