Inovalon

Inovalon is a leading healthcare software and analytics company that empowers payers, providers, pharmacies, and life sciences organizations with data-driven solutions designed to improve patient outcomes, business performance, and healthcare economics. By combining national-scale connectivity, real-time primary source data access, and advanced analytics, Inovalon delivers meaningful impact across the full continuum of care.

The company's platform and suite of products serve a broad range of healthcare stakeholders — from health plans managing quality performance and risk adjustment to provider organizations optimizing revenue cycle operations, and from specialty pharmacies streamlining dispensing workflows to life sciences companies seeking to optimize product life cycle strategy with industry-leading real-world data and analytics.

Solutions for Payers

• Sophisticated analytics and dynamic business intelligence to improve member care and outcomes while achieving greater performance.
• Converged Quality™ — an award-winning solution (Best in KLAS) that measures quality and improves care through predictive analytics enabling early detection of quality measure eligibility and driving timely interventions.
• Support for HEDIS reporting, regulatory reporting, and RADV audits, providing accurate and timely data that directly impacts state and federal program funding.
• Trusted by major health plans such as Aetna/CVS Health and WellSense for reliable, replicable, and complete quality data.

Solutions for Providers

• A single-sign-on, easy-to-use portal that integrates revenue cycle management, care quality management, and workforce management.
• Claims Management Pro — streamlines and automates claims processing with all-payer visibility to track, monitor, and manage appeals, helping organizations reduce denials and improve financial health.
• DataStream — transforms patient encounters with seamless data integration at the point of care, informing patient-centric decision-making.
• Safety management capabilities (including VigiLanz Safety Management) that help healthcare organizations build more robust patient safety processes by tracking, trending, and analyzing risk event data.
• Customers include PAM Health, Roots Food Group, CHRISTUS Health, and Community Health Network.

Solutions for Pharmacies

• Tools to streamline pharmacy operations and improve performance through automated processing, real-time data exchange, and electronic decision support.
• ScriptMed® Specialty — decreases time to fill and cost to serve while improving medication adherence through machine learning-powered adherence risk predictions.

Solutions for Life Sciences

• Analytics and primary source data solutions designed to optimize product life cycle strategy and performance.
• Access to industry-leading real-world data and research to support evidence generation and market insights.

Core Platform Capabilities and Data Assets

• National-scale connectivity providing access to real-time primary source data across the healthcare ecosystem.
• Advanced analytics and artificial intelligence, including machine learning models, with an emphasis on explainability and keeping humans in the loop.
• AI-driven tools addressing real-world healthcare challenges, with educational resources such as podcasts and on-demand webinars covering AI best practices, RCM strategies, and regulatory reporting.
• A free RCM ROI Calculator to help provider organizations quantify potential denial reductions and financial gains.

Inovalon's collaborative approach and commitment to accuracy have earned the trust of customers across the healthcare continuum, from large national health plans to regional health systems and specialty pharmacy operators, making it a comprehensive partner for data-driven healthcare transformation.