Inovalon Powers 70% of Medicare Advantage Enrollees in 4+ Star Plans, Continuing to Outperform National Averages in 2026 CMS Star Ratings

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BOWIE, Md.--(BUSINESS WIRE)--Oct 30, 2025--

Inovalon, a leading provider of data and solutions empowering data-driven healthcare, released results from an analysis conducted on customer performance for the 2026 Centers for Medicare & Medicaid Services (CMS) Star Ratings. The findings show that health plans using Inovalon’s Converged Quality ™ solution averaged 4.08 Stars, meeting the eligibility threshold for Quality Bonus Payments and outperforming the 3.98 national average.

Health plans use Inovalon’s Converged Quality solution to support quality reporting across regulatory clinical measure rates, quality improvement activity reporting, predictive cut point forecasting, and Medicare benchmarking, while receiving timely insights, data-driven intervention planning, and patient-level outreach informed by expert analytics.

Key highlights of Inovalon customers’ 2026 CMS Star Rating Performance:

• Health plans using Inovalon’s Converged Quality solution with Managed Services achieved 11% higher ratings than health plans using other solutions.
• 60% of all Medicare covered lives (20.9 million) and more than 70% of Medicare Advantage enrollees in 4+ Star plans (15.6 million of 22.3 million lives) are run through Inovalon’s software.
• Inovalon’s Converged Quality’s forecasted cut-point analysis demonstrated greater than 97% accuracy when compared with CMS-released cut points, providing predictive insights for plans to improve performance.
• Nearly 50% of all 5 Star plans use Inovalon’s data-driven insights.

“Achieving top-tier Star Ratings requires more than just meeting CMS requirements; it demands a proactive, data-driven approach that anticipates member needs and adapts to evolving performance expectations,” said Mike Jones, President of the Payer business unit at Inovalon. “Inovalon continues to raise the bar in our commitment to helping health plans achieve exceptional Star Ratings performance by delivering innovative solutions that health plans trust year after year, reinforcing our role as a dependable ally in navigating the complexities of the evolving CMS landscape.”

The Medicare Advantage landscape is undergoing significant transformation, with the slowing of enrollment growth, continued D-SNP expansion, and methodology changes in prior years directly impacting Star Ratings. While the average Star Ratings for all MA plans increased modestly from 3.95 in 2025 to 3.98 in 2026, the percentage of plans achieving 4+ Stars slightly declined from 40.9% to 40.1% in the same period. Looking ahead, the inclusion of the Excellent Health Outcomes for All index in 2027 and the ongoing transition to digital quality measurement will continue to shape plan performance. Join the Inovalon webinar to hear quality experts break down the 2026 CMS Star Ratings performance and these emerging trends.

As the nation’s most widely used healthcare quality data analysis and improvement platform, Inovalon’s Converged Quality is trusted by more than 100 leading health plans representing over 205 million covered lives to optimize quality measurement, reporting, and improvement initiatives. Built for real-time analytics, the solution goes beyond core reporting with add-ons for benchmarking, Star Ratings forecasting, medical record abstraction, analytics for population outcomes, and provider and member engagement. Integrated with Inovalon’s Converged Risk ™ solution, it also enables health plans to consolidate internal programs and vendors, improving oversight and streamlining operations.

For more information on Inovalon’s Converged Quality solution and Star Ratings, visit our website: https://www.inovalon.com/products/payer-cloud/quality/.

About Inovalon

Inovalon is a leading provider of data and solutions empowering data-driven healthcare. The Inovalon ONE® Platform brings together national-scale connectivity, real-time primary source data access, and advanced analytics into a sophisticated cloud-based platform empowering improved outcomes and economics across the healthcare ecosystem. The company’s analytics and capabilities are used by over 50,000 active, licensed customers, and are informed by the primary source data of more than 93 billion medical events across 1.1 million physicians, 706,000 clinical settings, and 416 million unique lives. For more information, visit www.inovalon.com.

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CONTACT: Tom Paolella

Sr. Director, Press and Analyst Relations, Inovalon

[email protected]

KEYWORD: MARYLAND UNITED STATES NORTH AMERICA

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SOURCE: Inovalon

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PUB: 10/30/2025 02:00 PM/DISC: 10/30/2025 02:00 PM

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