HIMSSCast: Devoted Health's 5-star rating success is due to its 'prime directive,' backed by tech
Two of company's MA plans earned 5 stars in 2024, during a difficult year to rank highly in the Medicare Advantage star ratings.
Photo: Tetra/Getty Images
This past October, when some of the bigger Medicare Advantage plans failed to get the 5 stars they had previously earned, the Massachusetts-based Devoted Health had two plans that earned the top rating.
In total for 2024, 31 contracts for Medicare Advantage and the Part D drug plans earned 5 stars, compared to 57 in 2023. It was called the "final fallout" from COVID-19, as CMS returned to a more business-as-usual approach after relaxing measures during the pandemic.
Not so surprised by the 5-star results was Devoted Health and its CMO Neil Wagle.
"The way we do that is through process control," Wagle said. "We make sure we do all the things that science knows, making sure we do that every time. The software we've purpose-built for this. We are very, very reliable in doing the things we know how to do."
Engineers purpose-built an all-in-one software platform for the company, including its EHR, called Orinoco, after the second largest river in South America. The name of the longest river in South America, the Amazon, was already taken.
For patient experience, they use the "prime directive," which includes having a live person answer the phone every time.
The tech-enabled Medicare Advantage company, founded in 2017 by Todd Park - who previously cofounded Athenahealth and Castlight Health – and by his brother, Ed Park, who held top positions at Athenahealth – is in 13 states and is growing. Devoted Health recently announced that it secured $175 million in Series E funding at the end of 2023.
For more about Devoted Health, please listen to the conversation with CMO Neil Wagle and Susan Morse, executive director of Healthcare Finance News.
Talking Points:
- Orinoco is the EHR. Every system, referral, sales authorization, pharmacy claim that comes in, is combined in Orinoco.
- Devoted Health is vertically integrated between payer and provider – and tech that powers both.
- Devoted MA plans are mostly zero premium and provide vision, dental and hearing.
- All of the medical care is free.
- 94% of Devoted members are in MA plans that rank at 4 stars or higher.
- Devoted shows 41% less hospital expenses compared to Medicare.
More About this Episode:
Medicare Advantage insurtech company Devoted Health secures $175M
See the Medicare Advantage 2024 star ratings list: Fewer plans earn 5 stars
Medicare Advantage star ratings this year represent 'final fallout' from COVID-19
Medicare Advantage startup Devoted Health rakes in $1.15 billion in Series D funding
Plans will be judged on HEI starting in the 2027 Medicare Advantage star ratings
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
