Medicare Insights

Effectively measure, monitor and manage Star Ratings with a comprehensive view of performance across all measures. Medicare Insights compiles datasets between contracts to simulate quality measure adjustments and operationalize engagement activities.

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Discover a Better Solution for Star Ratings Improvement

Medicare Insights serves as a cloud-based operational control tower that brings together necessary datasets into a uniform dashboard. Integrate medical claims, pharmacy records, Healthcare Effectiveness Data and Information Set (HEDIS®) measures, survey data, social determinants and other self-reported information. The centralized interface identifies critical quality improvement insights.

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Centralized Tracking

Consolidate all performance data into a single interface within Opportunity Manager and segment real-time data by contract, provider, measure and member.

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Star Score Simulator

Adjust the Star scores for specific measures based on performance data and enrollment rates to simulate the changes required to reach the next Star Ratings score.

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Segment Populations

Generate smart lists based on measure eligibility, social determinants of health, geography, chronic conditions and survey data to inform outreach campaigns.

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Instantly Act on Insights

Surface critical insights in an actionable dashboard and initiate member engagement campaigns, all within the same platform.


Provider-Level Reporting

Understand which measures are critical to performance, prioritized by provider, and if providers are making necessary adjustments.

Is Your Solution Producing Results?

Effectively measure, monitor and manage your Star Rating performance across all measures and contracts through Medicare Insights, allowing you to surface critical insights in real-time. With this valuable data at your fingertips, you can initiate interventions that influence health outcomes and quality improvement strategies.

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Maintained or increased Star levels by

0.5 Stars
for all clients in the 2022 Star Ratings
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Members engaged with Healthmine complete

4x more
health actions than unengaged members
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Healthmine users closed

1.7M care gaps
in 2021

Comprehensive Quality Improvement Insights with Opportunity Manager

Medicare Insights empowers Medicare Advantage plans with an unprecedented level of data access, real-time intelligence and transparency into the highest value activities to improve quality performance.

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Adaptable Technology

Proprietary predictive analytics show the exact number of members who need to be compliant to achieve the next Star.

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Advanced Reporting

Track and address Star Rating, quality measure, and engagement strategy performance at the member and provider level through real-time reporting.


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Quality Measure Calculator

Simulate quality measure performance changes in real time to identify what high-value measures to target to improve Star Ratings.

Featured Medicare Insights Resources

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