A new standard for quality in healthcare.
Regulators publish how health plans, hospitals and manufacturers perform. QPROi™ traces each published score back to the operating capabilities that produce it, then ranks what to fix first, for whom, and what it is worth.
Swipe sideways to follow the full trace.
It starts with Medicare Advantage
See the operation behind the Star Rating.
For health plans, QPROi™ reads public CMS Star Ratings back to the 74 capabilities a plan runs, ranks what to fix for members first, and finds the least-effort path to the next threshold. It starts before a single file is shared.
The health plan capability map
Nine domains and 74 capabilities: every function a plan runs. QPROi™ covers all of them across two phases. Select a domain to see its coverage. The named capability map is shown in the demo.
Why QPROi™
Leaders know their scores. The hard part is knowing which part of the operation to fix.
A Star Rating names the measure. It does not name the team, the process or the vendor behind it, or which fix helps members soonest. Analytics platforms need the plan's data before they can answer. Advisory work starts with weeks of interviews. QPROi™ starts with a defensible diagnosis from what CMS already publishes, then helps the plan act on it.
An outside-in diagnosis
A first read of the operation before any data-sharing agreement, IT project or interview schedule.
Experienced operators who help fix it
Every engagement is led by healthcare operating leaders. The technology does the analysis; people do the work with your teams.
Works with what you have
QPROi™ works alongside your analytics platform, quality vendors and advisors. It tells them where to focus.
How it works
From a public score to a ranked plan of action
Read the public record
Everything CMS publishes about the contract: measure results, multi-year trend, enrollment and benchmarks.
Connect measures to operations
Each measure is tied to the parts of the operation that drive it.
Find the shared causes
QPROi™ names the causes behind several weak measures at once, so one fix can lift many.
Rank what to fix first
Priorities are ordered by impact on members and measures, and by the effort to fix them.
Chart the next threshold
The least-effort path to the next star level, checked against CMS's own published method.
What a plan receives
A full Phase 0 diagnostic in two to three weeks
Delivered with a working session for the leadership team, through a private client portal with PDFs and executive briefs for the board and C-suite. Every figure is checked against its source before release.
- Executive Report
- Star position, cross-domain findings and ranked priorities in one place.
- Domain Diagnostics
- Capability-by-capability findings for Stars, Medical Management, Core Operations, and Provider and Vendor Governance.
- Master Diagnostic
- Every capability across every domain, with its measures, trend and status.
- Stars Simulation
- Value at each threshold and the least-effort paths to cross it.
- Stars Roadmap
- A phased remediation plan tied to the findings.
- Executive briefs
- Two-to-three-page briefs for each domain and a synthesis for the C-suite.
Star Ratings release outlook
Every release, a clear view of what moved and why
When CMS publishes new Star Ratings, QPROi™ publishes a market-wide outlook: how ratings shifted, which measures moved them, and where the operating pressure sits. Aggregate figures only. No plan is named.
Built on the 2027 Star Ratings, released October 8, 2026.
508 rated MA-PD contracts across 131 parent organizations. 188 (37%) reached 4.0★ or above, down from 229 (44%) in 2026; about 71% of MA-PD enrollees are in those contracts. Source: CMS 2027 Star Ratings data tables and fact sheet, October 8, 2026. The QPROi™ rating engine reproduces 1,619 of 1,621 published 2027 ratings; method notes are available on request.
How we work
Built to be checked
Public data first
The first diagnosis needs no data-sharing agreement and no IT project.
Real data only
QPROi™ uses published CMS data and, later, the client's own. No synthetic data.
Every figure verified
A numeric gate checks each number against its source before anything is released.
Clear about limits
Public-data findings are labeled as inferences until the plan's own data confirms them.
Engagements
Start with a snapshot. Grow into a program.
Each stage is a service engagement led by experienced operators, with QPROi™ doing the analysis underneath. Each one scopes the next.
Stars Snapshot
One page, in days
Your Star position, the value at stake and the top three priorities.
Phase 0 Diagnostic
Two to three weeks
The full public-data diagnostic set, delivered through the client portal.
Phase 1 Validation
Eight to twelve weeks
Your data confirms the findings across all nine domains.
Activation
One priority domain at a time
Remediation with KPI tracking against benchmarks.
Portfolio
Annual
Every contract, refreshed each Star Ratings release.
Partners
Built to work alongside the people who deliver quality
Healthcare consulting and advisory
Healthcare consulting and advisory for health plans and health systems. Naya and QPROi™ work together on joint engagements, from diagnosis through delivery.
Clinical intelligence partner
Patient-level clinical intelligence that finds unattended care needs. Paired with QPROi™, it connects plan and health system quality findings to the patients behind them.
Channel and delivery partners
Consultancies and quality vendors
Stars consultancies, quality vendors and actuarial firms can use QPROi™ as the front end to their own engagements, with a consistent method across clients.
For health plans and payers
See where your plan stands
Request a one-page Stars Snapshot for your contract: your position, the value at stake and the top three priorities. You can also view a full diagnostic on a sample plan. The demo runs QPROi™ on a de-identified Medicare Advantage plan, built entirely from real public CMS data.
- Stars Snapshot for your contract, free
- Demo: Executive Report summary, Stars Simulation and a sample Domain Diagnostic
- A call with our team to walk through your results
- A market summary of the latest Star Ratings release: what moved and why, with no plans named