As we recently announced our second year of NCQA HEDIS certification, I wanted to reflect on the tremendous achievements of the Lilac team. In under 18 months of active development, Lilac has built the most comprehensive Stars Platform in the market and it’s quickly gaining traction. I could not be prouder of how this team has delivered an extremely sophisticated solution in the complex environment of health plans in such a short time.
When we started Lilac, we set out to build a truly differentiating platform to help health plans and other risk-bearing entities to not only excel at Stars performance but also, and most importantly, improve the outcomes of seniors and those with disabilities.
We came together to develop a platform that does the following:
- Deliver the right data: Our unified data layer provides a key foundation to bring in data using existing formats and normalize and transform it. We add other data to the analysis to make the experience extremely data rich to identify both opportunities and barriers to care gap closure.
- Shortening the data lag: We solve the vexing data lags that hurt analysis and improvement in Stars. Our NCQA HEDIS certified and PQA licensed engine allows us to take in real-time data and assess it for member care gaps and performance.
- Comprehensive alignment: The platform is truly comprehensive, allowing executives and associates to align on the Star journey. We have included important forecasting, tracking, and strategy tools in the platform. At the same time, we have built in granular levels of detail to help Stars analysts research and close gaps.
- Intuitive insights and best practices: Our intuitive dashboarding and best practices allow Stars teams to quickly identify trends and execute on interventions. Since we update data daily, Stars teams are able to intervene much more often with members and providers. Our knowledge of healthcare operations allows us to help inform and leverage resources throughout the health plan enterprise to get to Stars goals.
- Game-changing AI: And now we are going deep on AI. From the beginning, we used AI and machine learning to improve our health plan achievement and cut point predictions. More recently, we have started introducing agentic AI use cases to analyze, streamline, and actually conduct outreach on behalf of different teams across our health plan clients. Finding qualified workers is a major challenge of health plans and the cost of good people can be prohibitive. Agentic AI helps tackle these problems by teaming up with Stars (and other) teams as copilots, analysts, and agents. Our use cases in the area of medication adherence and clinical and drug gap closures are cost-effective and expand the reach of the health plan.
I could not have imagined we would be where we are today, but consider all the hours we put into perfecting the following as prominent features of our platform:
- Looking at Stars data at the contract level as well as numerous other breakouts of the plan hierarchy.
- A revenue forecasting tool based on the complex Medicare Advantage rate-setting and quality bonus system.
- Grouping measures to develop common best practice approaches.
- Building all of the following into the platform:
- NCQA algorithms
- PQA algorithms
- CMS specifications for all 40-plus measures
- Forecasting measure performance based on a plan’s history
- Forecasting cut points based on years of CMS data
- CMS specifications for disaster, EHO4all, Reward Factor, CAI, improvement, summary ratings, domains, and overall ratings
- Best practice, data-rich chase lists and intervention strategies
- CMS Acumen to Plan reconciliation
- PDE validation
- Closeout and Plan Preview analysis
All that while onboarding clients! And I know I am forgetting so much.
Thank you team for all you have done. Working with you has been amazing. Look forward to the continued success. And thanks to Neetu Rajpal, Lilac’s CEO, for her incredible leadership.
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Interested in learning how your plan can benefit from all the great payer analytics and agentic AI solutions Lilac has built, reach out here to start a conversation with the Lilac team.
