Medicare Advantage organizations must excel across quality, risk, compliance, and financial metrics. These are the issues we hear about from Medicare Advantage leaders every day—and they’re exactly what Pareto solutions are built to solve.
Raising Star Ratings and identifying highest-value actions to optimize performance
Delivering insights that help organizations prioritize coding gap closure for accurate RAF scores and reimbursements
Staying audit-ready amid evolving CMS regulations
Engaging members in preventive care and chronic condition management
Our solutions deliver measurable outcomes and are built with an audit-ready foundation that ensures accuracy, transparency, and trust across every workflow.
by pinpointing the members, measures, providers, and interventions with the greatest impact, and continually track performance to sustain year-over-year gains. Pareto StarIQ helps plans forecast future performance and predict CMS measure cut points using historical and national trend data, so you can prioritize efforts before benchmarks are set. As CMS programs evolve, the platform adapts quickly and integrates seamlessly with your risk and quality data, turning siloed initiatives into one unified, strategic improvement plan.
with rewards tied directly to plan-level goals—closing gaps in care from preventive screenings to chronic condition management while strengthening member loyalty and retention.
by detecting care and coding gaps and documentation issues early. Pareto delivers defensible results with audit-ready reporting that aligns with CMS guidelines.
by identifying and correcting ESRD and MSP discrepancies. Pareto’s payment integrity solution generates timely recoveries and ensures the accuracy of ongoing premium payments from CMS.
Pareto combines integrated risk, quality, financial, and personalized member engagement analytics in a single platform with turnkey program execution—something not every vendor can say. Our Medicare Advantage expertise ensures every program is:
On June 28th, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released the Affordable Care Act (“ACA”) Risk Adjustment Transfer Payment results for the 2018 benefit year. Within days
We help plans see what’s driving performance and where to focus next. Using predictive analytics and modeling, Pareto pinpoints the measures and members most likely to improve Star outcomes.
We built compliance into all Pareto workflows, with audit-ready documentation, data traceability, risk mitigation models, and integrated reporting that aligns with CMS requirements.
Pareto calculates the financial impact of Star gains, looking at county benchmarks, rebate values and quality bonus payments.
Pareto Intelligence is a healthcare analytics and technology company that helps health plans improve quality, compliance, and financial performance. Our platform delivers actionable insights across risk adjustment, Star Ratings, payment integrity, and member engagement—so plans can recover revenue, close gaps, and stay CMS-ready.
For Medicare Advantage plans, Pareto focuses on optimizing RAF accuracy and reducing compliance risk—backed by predictive analytics, turnkey execution, and transparent results tracking.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
