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URAC and Inovalon Partner to Provide Performance Measurement Reporting to CMS

Tuesday, November 4th, 2014

November 4, 2014 ― URAC, a leader in promoting healthcare quality through accreditation, education, and measurement programs, announced that it has entered into a partnership with Inovalon, a leading technology company that combines advanced cloud-based data analytics and data-driven intervention platforms to achieve meaningful impact in clinical and quality outcomes, utilization, and financial performance across the healthcare landscape.

The strategic partnership will make the industry’s most robust analytics platform available to URAC-accredited health plans, including Qualified Health Plans (QHP) participating in the Health Insurance Marketplace, and will empower URAC with a comprehensive set of tools and data to advance new evidence-based methods to measure quality.

“URAC is excited to be partnering with Inovalon. Quality-driven healthcare is crucial to our nation’s welfare and the reporting of performance measures helps assess the impact of these programs on a dynamic basis,” said URAC President and CEO Kylanne Green. “URAC has invested in multiple years of research, evaluating a variety of options, to ease the reporting burden for our accredited QHP clients. After a rigorous analysis, Inovalon was chosen as the optimal partner to make that goal a reality.”

The quality measures are to be reported to the Centers for Medicaid & Medicare Services (CMS) in support of the Final 2015 Quality Rating System Beta Test Measure Set and the final rule for Exchange and Insurance Market Standards for 2015 and Beyond.

“Data is critical to driving quality improvements, enabling accredited organizations to understand and provide meaningful comparisons amongst their accredited entities,” said Dan Rizzo, Chief Innovation Officer, Inovalon. “As more of the healthcare system adopts standards for quality measurement, from pharmacy accreditation programs in the areas of specialty pharmacy and community pharmacy, to provider care integration and coordination programs, we’ll see many more opportunities for data and measurement to inform and empower meaningful change.”

The strategic partnership with Inovalon will allow URAC to focus on its industry leading expertise in developing innovative programs to promote healthcare quality and guide clients through the rigorous and comprehensive process of accreditation. URAC offers the largest array of accreditation programs in the United States assessing health plan operations, including but not limited to, network operations, healthcare practitioner credentialing systems, and medical management functions (such as utilization management, case management, disease management, and health call center services).


For 25 years, URAC has been the independent leader in promoting health care quality through accreditation, education, and measurement. URAC offers a wide range of quality benchmarking programs that reflect the latest changes in health care and provide a symbol of excellence for organizations to showcase their validated commitment to quality and accountability. URAC’s evidence-based measures and standards are developed through inclusive engagement with a broad range of stakeholders committed to improving the quality of health care. For more information about URAC, contact us.

Inovalon is a leading technology company that combines advanced cloud-based data analytics and data-driven intervention platforms to achieve meaningful impact in clinical and quality outcomes, utilization, and financial performance across the healthcare landscape. Inovalon’s unique achievement of value is delivered through the effective progression of Turning Data into Insight, and Insight into Action®. Large proprietary datasets, advanced integration technologies, sophisticated predictive analytics, and deep subject matter expertise deliver a seamless, end-to-end platform of technology and nationwide operations that bring the benefits of big data and large-scale analytics to the point of care. Driven by data, Inovalon uniquely identifies gaps in care, quality, data integrity, and financial performance—while also bringing to bear the unique capabilities to resolve them. Supporting hundreds of healthcare organizations in 97.8% of U.S. counties and Puerto Rico, Inovalon’s analytical and data-driven intervention platforms are informed by data pertaining to more than 719,000 physicians, 229,000 clinical facilities, and more than 112 million Americans, providing a powerful solution suite that drives high-value impact, improving quality and economics for health plans, ACOs, hospitals, physicians, patients, and researchers. For more information visit www.inovalon.com.



Inovalon, Inc.
Kim E. Collins
4321 Collington Road
Bowie, Maryland 20716
Phone: 301-809-4000 x1473

David Almasi
1220 L Street, NW, Suite 400
Washington, D.C. 20005
Phone: 202-962-8803

Interested in accreditation?
Contact businessdevelopment@urac.org

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