Verscend Solidifies Leadership in Healthcare Quality Improvement with New Solution for Star Ratings Optimization

Star Navigator intensifies Verscend’s support for Medicare Advantage plans participating in CMS’s Five-Star Rating System, enabling plans to efficiently collaborate with providers to meet quality standards, attract new beneficiaries, and achieve performance-based financial incentives

Please note that Verscend Technologies, Inc. is now Cotiviti, Inc.


WALTHAM, MASS. – July 16, 2018 – Verscend Technologies, Inc. (Verscend), a leader in data-driven healthcare solutions, has introduced Star Navigator, a new quality improvement solution that empowers Medicare Advantage plans to determine the most direct path to higher Star Ratings, then track and communicate their progress toward goals. The Five-Star Rating System, administered by the Centers for Medicare & Medicaid Services (CMS), rates Medicare Advantage Part C and Part D plans on up to 44 unique quality and performance measures. Performing well in this program is an indicator that a plan is ensuring its Medicare Advantage members receive high-quality care, for which a plan can receive financial incentives. Conversely, low-performing plans can face corrective actions.

“Verscend’s portfolio of payer solutions comprehensively supports payers with three very significant needs: quality improvement, risk adjustment, and payment integrity. The ability for plans to effectively partner with providers to ensure members receive the best possible care drives exceptional performance not only throughout their specific organization but across the industry, which is why Verscend is so committed to investment in this area,” said Emad Rizk, M.D., president and CEO of Verscend. “Verscend has been helping Medicare Advantage plans close care gaps and improve their performance on quality measures with our Quality Intelligence solution for decades, with excellent outcomes. More than 50 percent of our clients have earned an overall rating of four stars or higher. Star Navigator will help them even further by providing the ability to see exactly what they need to do on a granular level to boost their performance.”

“Optimizing our Star Ratings performance is crucial to our ability as a health plan to provide better care for our members as well as enroll new members,” said Dominic Henriques, director of performance improvement for Prominence Health Plan, a beta development partner for Star Navigator. “A dedicated solution such as Star Navigator can help us model different scenarios to improve our Star Ratings while partnering effectively with providers to reduce gaps in care.”

Star Navigator is a component of Verscend’s end-to-end quality improvement solution, which blends Quality Intelligence, the company’s award-winning quality analytics and reporting software, with high-volume, expert retrieval and abstraction services for overall process excellence. Star Navigator can be added to any Quality Intelligence implementation to enhance the software’s ability to provide Star Ratings intelligence and more efficient workflows.

With Star Navigator, health plans gain the insights necessary to efficiently close care gaps, enlisting providers as partners in quality improvement while providing a better member experience. The software eases the process of tracking annual CMS changes to the program and requires minimal IT support, thus providing a turnkey solution for Star Ratings optimization. The solution’s key capabilities include:

  • Results modeling to identify the impact of each Star Measure on the related Summary and Overall Ratings, helping identify the best improvement strategy
  • Customized dashboards to monitor specific measures for easy progress tracking
  • Identification of non-compliant (gapped) members by measure or across all measures to improve outreach
  • Shareable provider-specific dashboards and provider scorecards to improve partnership
  • Measure-specific recommendations for improving Star Ratings via outreach and intervention techniques
  • Simplified data integration with Verscend’s HEDIS solutions to speed implementation and reduce IT support needs


About Verscend Technologies, Inc.
Verscend Technologies (formerly Verisk Health) drives better healthcare outcomes through data analytics, supporting payers' financial performance and quality improvement initiatives. Our Payment Accuracy, Risk Adjustment, and Quality and Performance solutions help organizations utilize their data so they can efficiently and cost-effectively succeed in the new era of healthcare. Learn more at


Media Contact
Jeffrey Robinson, Verscend Technologies
(781) 693-3717