Medicare Advantage quality intelligence

Clear Insights,5 Star Outcomes.

Medicare Advantage Star Ratings analytics that turns quality data into answers you can act on today, and shows its work.

Apply to our Pilot CohortFree Star Ratings dashboard (in maintenance)

Compliance is not a feature we bolt on. It is encoded into every prompt, every repository, and every system design from the first line.

HIPAA compliant today. See our Trust Center for our security and compliance posture.

Quality intelligence for Medicare Advantage, on one governed foundation.

We help Medicare Advantage plans and the provider groups they partner with see their Star Ratings clearly, act before the measurement year closes, and prove the result. Deep domain expertise paired with deterministic AI, so a question from the executive suite, the analytics team, and the care team all resolve to the same trusted answer. No black boxes. No invented numbers. Precision you can trace to the source.

What we do for health plans

Healthcare is drowning in data and starving for answers.

Quality leaders know what the strategy should be. They are just stuck waiting on a ticket to get the numbers, and by the time the report lands, the measurement year has moved on. Analytics teams burn out rebuilding the same rolling report into one more ad hoc variation. Clinicians get handed gap lists compiled before the visit was booked, disconnected from the patient in the room.

With the measure set tightening and the math shifting every year, slow and opaque is no longer survivable. The real problem is not a missing dashboard. It is the gap between payer strategy, technical reality, and clinical execution.

Products

Three engines. One source of truth.

ClearStars is built as three connected platforms on one governed data foundation, so a question from the C-suite, the analytics team, and the care team all resolve to the same trusted answer.

In the order they are sold: public data first, plan data second, protected health information last. Each step earns the right to ask for more access.

  1. CMS Star Ratings intelligence

    ClearStarsQI

    See your Star Ratings performance against CMS cut points, identify bubble measures, and model the math to your target rating. No protected health information, no BAA, fastest to deploy.

    Explore ClearStarsQI
    Protected health information
    None
    Agreement
    None needed
    Foundation
    One governed data layer, shared by all three

  2. Deterministic workflow AI

    ClearStarsQI+

    Ask your quality data a question in plain English and get a precise, sourced answer, down to the claim event that moved a member in or out of a measure. It shows its work and it does not invent your numbers.

    Explore ClearStarsQI+
    Protected health information
    Required
    Agreement
    Business associate agreement
    Foundation
    One governed data layer, shared by all three

  3. Clinical outcomes engine

    ClearStarsLM

    Connect quality performance to clinical outcomes and value-based care results, so improvement work is prioritized by patient impact rather than by checkbox.

    Explore ClearStarsLM
    Protected health information
    Required
    Agreement
    Business associate agreement
    Foundation
    One governed data layer, shared by all three

The Glass Box

We do not hide our logic. We show our work.

Most AI in healthcare is a black box. You get an output and you are asked to trust it. In our line of work, a data error is not a bug, it is a patient missed or a revenue clawback. So we built the opposite. Every answer carries its lineage. Every classification is visible. Every number can be traced to the source.

A question, asked in plain English

Which measure moved our rating this quarter, and why?

The answer, with its work shown

Controlling high blood pressure fell below the four star threshold. The drop traces to one health system whose structured result field stopped populating after an EHR change in July. Claim volume is unchanged, so this is a data capture gap, not a care gap. Re-map the field and backfill the measurement year before it closes.

Measure
Controlling high blood pressure, weight 3
Evidence
Numerator down, denominator flat, concentrated in one source feed
Source record
Clinical result feed, structured field, July onward
Logic version
Published measure specification, current measurement year

Illustrative. Synthetic data only. No protected health information.

A smarter way to understand and improve performance.

Deterministic AI

Engineering, not magic. Precise answers grounded in the public quality and CMS record.

Predictive Star modeling

Cut point projections and scenario modeling, so you see your moves before the year closes.

Automated quality workflows

Gap intelligence and chase list prioritization that free your team from the report desk.

Integrations with governance built in

Connects to your quality and performance data with governance built in from the start.

Compliance by design

HIPAA compliant today. Synthetic data only in development and demos. See our Trust Center for the full security posture.

Built for the organizations that carry the work.

Managed care plans

Medicare Advantage and Medicaid managed care

See your cut point exposure at the start of the measurement year, not the end of it. Walk into the executive suite with a ranked, dollar weighted plan, and into an audit with a number you can defend to the source record. Start on published CMS data with nothing to sign, and earn your way to member level intelligence when you are ready.

What we bring

Value based care organizations and provider groups

ACOs, IPAs, and provider sponsored plans

A short, prioritized list tied to the patient in the room rather than a gap report compiled before the visit was booked. Clinical quality measured on the FHIR data you already produce, ranked by outcome, on a cycle short enough to close a gap inside the year. Built for the way quality measurement is going, not the way it was.

What we bring

Third party vendors and consultants

Firms that need data support behind their own delivery

Your clients trust you with the outcome. We supply the governed, documented quality data foundation underneath it: built to your specification or run on our runbooks, with lineage on every rate and a handoff written well enough that your team can carry it without us. Your client relationship stays yours.

What we bring

We are not dashboards. We are answers.

Deterministic, not magic.

Our AI is engineering, a precise tool that gets it right. Every financial and measure calculation runs on a deterministic path, so no sensitive number is ever generated. The language layer reports validated results and computes nothing.

Infrastructure partners, not vendor number forty-two.

We do not ship and walk away. The same people who build the models run the platforms underneath them, which is why services and product are one business rather than two.

Signal over noise.

We build the dam, we do not add to the flood. One governed foundation answers the executive, the analyst, and the care team with the same number, instead of three reports that disagree.

Insights

Expert perspectives on quality and Stars.

Analysis on Medicare Advantage Star Ratings, digital quality measures, and the future of healthcare data, sourced to Tier-1 references.

Read our insights

Value-Based Care

The Margin Squeeze Is Real: Why Quality Bonus Dollars Matter More in 2027

For most of the last decade, Medicare Advantage growth covered a lot of operational sins. Rates rose, enrollment climbed, and a plan could carry a mediocre Star Rating without feeling it in the margin. That era is over. With the final 2027 rate set against medical costs that have run hot across the industry, the gap between a 3.5-star plan and a 4-star plan is no longer a quality-department talking point. It is a line on the income statement. Quality bonus dollars have quietly become one of the few margin levers a plan still controls, and most plans are underusing it. CMS finalized a net effective growth rate of about 2.48 percent for 2027, which the agency estimates as an increase of more than $13 billion in payments to plans.

Continue reading →
Jun 7, 202610 min read

Digital quality measures

Quality measurement is going fully digital. Here is what changes.

NCQA plans to retire the legacy hybrid method by measurement year 2029 and move to fully digital reporting by 2030, with measure logic published in FHIR and CQL. Here is what that shift means for Medicare Advantage quality and analytics teams.

Jun 6, 202612 min read

See your Stars performance the way it should work.

Bring your hardest question.

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