Without member level insight into RAF value and Star impact, there's no way to defend your budget or improve strategy.
When quality, risk, and marketing teams run separate campaigns, members receive mixed messages and your plan pays twice.
Most rewards programs engage members who would have acted anyway while missing the ones who actually move the needle.
The Pareto RewardsIQ solution is a fully configurable, data-driven program designed to help health plans achieve their quality, risk adjustment, member engagement, and retention goals.
Built for Medicare, Medicaid, ACA, and Commercial populations, our platform transforms rewards into results—leveraging predictive analytics, omnichannel engagement, customizable reward types, and real-time performance reporting.
We manage the entire process—from client-centered program design and member fulfillment to analytics and reporting—so your team can stay focused on strategy and outcomes that move the needle.
With Pareto, rewards are more than transactions—they’re a strategic lever for measurable health outcomes, member engagement, and plan performance.
Pareto’s Rewards & Incentives program is built for cross-functional health plan leaders who need a compliant, data-driven approach to member engagement and activation that delivers measurable results.
Whether your focus is growth, performance, or experience, Pareto helps align every engagement to your plan’s strategic priorities.
Who are designing competitive benefit offerings that attract and retain members.
Who are interested in member activation that builds trust, increases member satisfaction, and closes gaps in care.
Who are looking for member engagement and activation platforms that enable coordinated and orchestrated member journeys connecting members to their care, improving health outcomes, and strengthening plan loyalty.
Too many plans rely on one-size-fits-all approaches. Pareto gives you a strategic, data-driven, and personalized alternative.
Our predictive, and fully managed platform delivers measurable results.
Incentives focused on the members, measures, and moments that drive real ROI
Real-time dashboards and longitudinal reporting
Pareto supports plans with a myriad of R&I program configurations, including reward delivery, engagement strategies, and portal architecture. We align it all to your design preferences, including flex cards, gift cards, and curated catalogs.
Designed, deployed, fulfilled, and optimized around your team’s strategy
Unlike other vendors, we have access to the data and analytics needed to understand each member’s journey, predict their next best action, and design personalized outreach that drives meaningful behavior change. We also quantify the value of those actions by connecting engagement to outcomes such as risk adjustment performance, Star Ratings improvement, and member retention.
We use clinical risk, engagement history, and real-time data to identify which members will respond and which actions are most likely to drive ROI. That means smarter targeting, backed by measurable Star, quality, and RAF lifts.
Reporting, dashboards, and ROI attribution are tied directly to quality, engagement, and financial outcomes. With Pareto RewardsIQ you are tracking impact, not just activity.
Pareto RewardsIQ is just one piece of a broader strategy to help plans drive performance across Star, quality, risk adjustment, and member activation.
Explore the tools that help you engage more effectively, code more accurately, and perform more confidently.
Target high-need members for AWVs, screenings, medication adherence, and chronic care actions.
Align incentives to coding accuracy and high-value member actions that improve risk scores and revenue accuracy.
Design incentives and campaigns in ways that move CAHPS, close clinical gaps in care, and improve member satisfaction.
Count on turnkey implementation, fulfillment, and reporting that reduces internal burdens and keeps your team focused on strategy.
Incentives shouldn’t be guesswork. Pareto’s predictive member targeting engine identifies the highest-impact opportunities, and is built for precision, accountability, compliance, and plan alignment.
Predictive analytics flag high-yield members and behaviors.
Incentives are mapped to plan goals and regulatory requirements.
Omnichannel health plan communication includes SMS, email, mail, IVR and inbound/outbound calls to power frictionless reward redemption.
A/B testing and real-time reporting power continuous improvement.
Yes. Pareto’s flexible reward options—including gift cards, curated catalogs, and flex card incentives—are configured to your plan’s population, budget, and compliance requirements.
We connect incentives to Star measures, RAF value, and member-level outcomes, and deploy dashboards and defensible reporting to drive quality improvement through targeted, compliant outreach.
Pareto RewardsIQ is up to speed on all CMS marketing and managed care requirements so you can rest assured that the rewards program is equitable and compliant.
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
A yearly preventive care visit covered by Medicare, often incentivized to support early detection and engagement.
Structured documentation and analytics designed to support compliance reviews and withstand regulatory audits.
A member satisfaction survey that contributes to Star Ratings and Quality Ratings in other lines of business.
Alignment with Centers for Medicare & Medicaid Services (CMS) regulations to ensure programs are auditable and safe from corrective actions.
A reloadable prepaid card offered by health plans that members can use for eligible health-related expenses, often included in incentive programs.
Strategies used to encourage plan members to take proactive steps in their health—key to improving outcomes and plan performance.
The use of data science and modeling to identify the members most likely to respond to specific incentives or engagement strategies.
Measures that are designed to reflect the quality of a member’s care access, care outcomes, and experience. In Medicare, this is referred to as Star Ratings, and other lines of business also have their respective quality rating systems.
A score that reflects the health status of members and adjusts payment levels to plans accordingly; used to ensure accurate reimbursement.
A CMS system used to measure the performance of Medicare Advantage plans across quality, service, and member satisfaction metrics.
A healthcare model that reimburses providers based on health outcomes rather than volume of services.
Pareto Intelligence is a healthcare analytics and technology company that helps health plans in government-sponsored markets improve financial performance and regulatory compliance. We delivers actionable insights across premium reconciliation, risk adjustment, Stars, and member engagement—so plans can recover revenue, close gaps, and stay CMS-ready.
With solutions like RewardsIQ, Pareto helps plans engage the right members at the right time, align outreach with performance goals, and drive measurable improvements in Stars, retention, and quality outcomes.
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.
