Medicare Advantage strategy where every number traces to its source.
The objective intelligence layer for regional Medicare Advantage health plans. Simulate Tukey cut points, model Quality Bonus Payment exposure, and optimize supplemental benefits with 100% deterministic rate-book fidelity.
Explore Core Capabilities & Roadmap
Maven delivers an expanding operating suite across the annual Medicare Advantage calendar—from fall Star Ratings defense to spring bid design and summer network contracting.
Star Ratings & QBP Capital Protection
Quantify 3.5★ cliff risk, simulate Tukey outlier cut-point movements, and prioritize high-weight clinical care gaps to defend Quality Bonus Payment liquidity.
Plan Benefit Package (PBP) & Bid Knapsack
Side-by-side competitor benchmarking of supplemental benefits (Dental, OTC Flex cards, $0 copays) paired with margin-yield knapsack optimization for annual bid filing.
Network Adequacy & HSD Guardrails
Provider contracting negotiation tool with automated 42 CFR § 422.116 time and distance compliance warnings for hospital carve-outs and parent system recruitment.
Part D Formulary Economics
Inflation Reduction Act (IRA) $2,000 out-of-pocket cap modeling, specialty tier cost-sharing analysis, and manufacturer rebate elasticity tracking.
Risk Adjustment & V28 Transition
Diagnose revenue erosion from V28 diagnostic phase-ins, pinpoint unrecaptured chronic condition gaps, and audit RADV defensibility.
Maven Actuarial Simulation Labs
Proprietary cut-point forecasting models and member enrollment churn simulations, with transparent methodology disclosures and confidence intervals.
Deterministic math. Zero black-box guesswork.
Test real CMS 2027 cut-point shifts and inspect our signature data provenance. Every figure links directly to its official federal table and SHA-256 ledger.
Drag the Tukey outlier fence slider below to simulate how removing extreme statistical outliers reshapes the unrounded composite score and triggers the 3.5★ to 4.0★ Quality Bonus Payment cliff:
The CY 2027 Star Ratings Shockwave Explained
Watch our 2-minute visual breakdown of how Tukey outlier deletion compressed cut points and wiped out $1.72B in national rebate revenue.
Frequently Asked Questions
Direct answers for Chief Actuaries, Chief Executive Officers, and Quality Leaders evaluating Maven Healthcare Intelligence.
Does Maven require Protected Health Information (PHI) or a BAA?
No. Maven operates strictly on publicly available CMS open data, statutory rate books, and federal regulatory filings. Because zero PHI touches the platform, health plans can engage Maven and receive our 48-hour diagnostic without multi-month HIPAA or Business Associate Agreement delays.
What is the Data Integrity Protocol (DIAP)?
DIAP is Maven's strict provenance governance protocol. Under DIAP, every quantitative assertion links directly to an immutable federal source table and release vintage. No figure is ever calculated or estimated by a large language model; all math executes deterministically in auditable SQL.
How does the 48-Hour Boardroom Diagnostic turnaround work?
Because our nationwide DuckDB analytical warehouse pre-computes CMS data for all Medicare Advantage contracts, our actuarial team generates your plan's bespoke 16:9 presentation deck and dynamic Excel model within 48 hours of engagement sign-off.
What does the Design Partner Charter License include?
Initial regional health plans that convert their $75,000 diagnostic into an Annual Enterprise Platform Subscription receive locked-in charter terms: all-inclusive access to all upcoming roadmap modules (PBP Bid Engine, Network Adequacy, Part D) launched during their term at no additional licensing cost.