Expert Advisory Services
Wherever you are in your performance improvement journey, Healthmine’s consultants guide you to the actions needed to impact the right measures, evaluate market dynamics and opportunities, optimize distribution channels and fulfill strategic planning needs.
Leverage Our Consulting Team's Extensive Industry Experience
Rooted in data analysis, Expert Advisory Services focuses on helping our health plan and provider partners improve performance, create 5-Star experiences, implement holistic population health programs and reduce costs.
All-Inclusive
We consider the clinical, operational and network opportunities to improve performance with a focus on emerging technical, competitive and regulatory requirements.
Purpose-Built
We seek short- and long-term solutions to help accomplish your goals as quickly as possible.
Data-Driven
We develop informed strategies to improve performance, address HEDIS®, Prescription Drug Event, CAHPS and Health Outcome Survey measures, and support successful value-based care and clinical integration initiatives.
Enriching
Our consultants provide real-time guidance to hardwire best practices into your routine operations and infrastructure for continuous, long-lasting success.
Informed
Our in-depth understanding of Star Ratings strategies for success, HEDIS® measures and NCQA's transformation to digital quality measurements enables you to rapidly adapt to an evolving industry.
Adopt New Strategies
Navigate New Risk Adjustment Rules
Prepare your organization with the right practices to address Risk Adjustment Data Validation.
Evolve Your Stars Strategies
Get ahead of the upcoming changes to the Star Ratings program with six tips for aligning your internal strategies.
Review New Stars Regulations
Update your Stars work plans with an in-depth analysis of the 2024 Medicare Advantage Final Rule.
Meet the Team
Every team member has more than 15 years of experience working with hundreds of health plans and has first-hand knowledge of health equity, digital quality measurements and regulatory compliance.
Melissa Smith
Melissa is a well-known thought leader and healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, HEDIS scores, quality performance, health outcomes and the member experience. As Chief Consulting Officer, she helps clients evaluate market dynamics and opportunities, optimize distribution channels and fulfill strategic planning needs.
John Willis
John Willis is a quality improvement expert with over 20 years of experience guiding managed care plans to success. Having worked in Stars since its inception, he has a proven track record of building out turn-key strategies that enable Medicare Advantage plans to boost Star Ratings. He has significant experience working with Medicare Advantage, Dual-Eligible Special Needs Plans, Individual Special Needs Plans to improve member experiences and quality scores.
Cynthia Pawley-Martin
Cynthia Pawley-Martin has a wealth of expertise from her long-tenured career as a healthcare quality improvement professional. She has consulted with dozens of Medicare Advantage plans on their Star Ratings programs and comes with a solid record of success leading and supporting quality programs across healthcare delivery systems, including health plans and large physician practices.
Services
Led by the industry’s foremost experts and thought leaders, Healthmine will help you create, assess, enhance and implement a strategy to achieve and maintain the highest quality ratings and service excellence.
Star Ratings Assessment & Improvement
CAHPS Improvement & Member Experience Optimization
HEDIS Reporting, Processes & Digital Quality Measurement Transformation
Quality Improvement Program Development & Redesign
Population Health Program Development & Redesign
Member & Provider Engagement and Experience
NCQA and Health Equity Accreditation
Model of Care Development & Audit Readiness
Plan Operations & Clinical Integration Strategies
Risk Adjustment & Value-based Care Strategies & Transformation
Markets We Serve
- Medicare Advantage (MA)
- Dual Special Needs Plans (D-SNP)
- Medicaid
- Integrated Health Plans and Systems
- Affordable Care Act (ACA)
- Risk-Bearing Providers and Accountable Care Organizations (ACO)