The objective, deterministic intelligence layer for Medicare Advantage health plans. Protect Quality Bonus Payments, simulate Tukey cut-point shifts, and command provider contracting leverage with zero LLM math.
CMS's enforcement of Tukey 3.0x IQR outlier deletion (42 CFR § 422.166) and 5% guardrails compressed cut points upward across clinical and member experience measures, sparking unprecedented industry revenue volatility.
National 4.0+ Star contract percentage fell from 64.7% to 56.9% ex-Humana, forfeiting billions in supplemental benefit funding.
Independent regional HMOs across NY, OH, TN, CA, and FL fell from 4.0/4.5 Stars to 3.5 Stars, incurring -$30 to -$80 PMPM rebate cuts.
In qualifying SSA § 1853(o)(5) counties, dropping below 4.0 Stars creates an asymmetric +$100 PMPM gross rebate deficit against competitors.
Engineered for health plan Chief Executive Officers, Chief Actuaries, and Quality CMOs requiring mathematical certainty over consulting generalities.
Calculates county-weighted gross benchmark uplifts, statutory rebate sharing tiers (65% to 50%), and exact net supplemental benefit pool shocks.
Stack-ranks focal contracts against regional market leaders by measure weight (5x, 3x, 2x, 1x) with exact patient care gap volume calculus.
Grounds provider networks on 5,419 certified hospitals with CCNs, official CMS Hospital Star Ratings, and hospitalist specialist exclusion toggles.
Actuaries and C-suites cannot make nine-figure decisions on black-box estimates. Maven operates on deterministic, fail-closed mathematical verification.
An intensive, board-level partnership delivering unassailable actuarial proof and clinical care-gap roadmaps to protect your Quality Bonus Payments ahead of the next payment cycle.
100% of the pilot fee is credited directly toward an annual enterprise subscription upon Day 75 renewal.
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