CMS1 Partners™ — Driving Success | Quality as a Financial Lever
Portfolio of Outcomes  ·  IPAs  ·  Multi-Specialty Groups  ·  MSOs  ·  8 Active Engagements  ·  New York Metro & National  ·  2024–2026

CMS1 Partners™ — Driving Success Across Our Client Portfolio

Your Quality Performance
Is Your Negotiating Position.

Star Rating Strategy  ·  HEDIS Gap Closure  ·  MA Contract Renegotiation  ·  Value-Based Care Performance

CMS has been explicit: Star Ratings determine plan revenue — and plan revenue determines how aggressively your payer sits across the table from you. The organizations that grasp this distinction do not just perform better clinically. They renegotiate from a position of documented, undeniable leverage.

Total Incremental Revenue — CMS1 Partners Client Portfolio

$0.0M
↑ 8 Client Engagements · 24 Months · 2024–2026

Generated through Star Rating improvement, MA contract renegotiation, HEDIS gap closure, and value-based care performance optimization across a diverse portfolio of IPAs, multi-specialty groups, and managed care organizations.

0.0
↑ from 3.1 weighted avg baseline Portfolio Avg. Star Rating Achieved
0.0%
↑ Blended rate improvement Avg. MA Contract Rate Lift
$0.0M
↑ 5 VBC arrangements activated Value-Based Shared Savings Captured
0.0 pts
↑ HEDIS composite avg improvement Quality Measure Point Gain
3 / 5
↑ Advanced from below 4.0 Stars MA Clients Achieved 4.0+ Star Rating
$0.0M
↑ Incremental quality incentive earned P4Q / Quality Bonus Pool Captured

Three representative MA client trajectories across eight measurement quarters. The 4.0-Star threshold is not just a clinical milestone — it is the inflection point at which contract leverage materially shifts.

+1.1
↑ Avg. star improvementMean Rating Gain Across MA Clients
3 / 5
↑ From below 4.0 StarsMA Clients Crossing 4.0★ Threshold
12
↑ Avg. 18.3 pts per measureHEDIS Star Measures Improved
$6.8M
↑ Incremental over baselineQuality Bonus Pool Secured

Star Rating Trajectory — Three Client Profiles

Q1 2024 → Q4 2025 · Gold = IPA (NYC) · Green = Multi-Specialty (NJ) · Blue = MSO-Managed Group · Dashed = 4.0★ Quality Threshold

Across all engaged clients, CMS1 Partners implemented prospective and retrospective HEDIS gap-closure programs, targeting the six highest-weight Star Rating measures. Portfolio-average performance improvement shown below.

HEDIS Measure Improvement — Before vs. After Dumbbell

Muted circle = Prior Performance  ·  Gold circle = Current Performance  ·  Portfolio average across all engaged clients

Renegotiated Medicare Advantage agreements, armed with documented Star Rating improvement and quality data, drove direct rate improvements. The 100% FFS parity line marks the industry benchmark — we moved clients above it.

88.4% prior
108.1%
↑ +19.7 pts above FFS
Blended MA Primary Care vs. FFS
84.2% prior
103.7%
↑ +19.5 pts above FFS
Blended MA Specialist Rate vs. FFS
$2.1M prior
$6.8M
↑ +224% Total Pool
P4Q Quality Incentive Earned
$0 prior
$8.4M
↑ Net-New Revenue Stream
VBC Shared Savings Secured

Contract Rate Achievement — % of Medicare FFS by Category

Muted bar = Prior rate · Gold extension = Improvement gained · Dashed line = 100% FFS parity benchmark

Five distinct VBC arrangements activated and optimized across the CMS1 Partners portfolio — spanning ACO performance, cardiology co-management, global risk, disease management, and behavioral health integration.

$8.4M
↑ 5 ArrangementsTotal Shared Savings Captured
88.4%
↑ from 71.2% avgAvg. Quality Score vs. VBC Threshold
−7.3%
↓ vs. risk-adjusted benchmarkAvg. Cost Reduction (VBC Clients)
$1.68M
↑ Avg. per arrangementMean Shared Savings per VBC Client

Shared Savings Captured — by VBC Arrangement Type

Gold bars = Savings captured in $M · Each arrangement independently optimized under CMS1 Partners strategic guidance

Four integrated workstreams, executed as a unified strategic engagement. Each pillar reinforces the others — because quality performance, contract leverage, risk capture, and care efficiency are not separate conversations.

01
HEDIS Acceleration & Star Rating Strategy
Prospective and retrospective gap closure across all high-weight Star measures. Physician-level performance tracking, patient outreach integration, and CMS measure audit methodology — targeting the specific measures where your organization has the most leverage per point gained.
02
Payer Contract Renegotiation & Rate Intelligence
Data-driven MA and commercial contract renegotiation using your documented quality performance as the anchor. We analyze your payer’s rate structure against regional benchmarks, model PMPM uplift scenarios, and build the negotiating package your medical director needs at the table.
03
Value-Based Care Architecture & Performance Management
VBC arrangement design, shared savings modeling, attribution analysis, and ongoing performance management. We translate clinical initiative into documented contract performance — ensuring your group captures the savings you’ve already earned but haven’t yet claimed.
04
HCC / Risk Adjustment & Utilization Optimization
V28 HCC capture programs, RAF score improvement strategy, and prospective coding workflows aligned with CMS RADV audit standards. Coupled with UM redesign to reduce authorization friction and denial rates — together, these drive net revenue without adding volume or headcount.
0%
CMS, HIPAA, Stark & False Claims Act Adherence Across Portfolio
0
Client Compliance Incidents Across All Engagements
0
OIG / CMS Audit Findings Attributable to Engagement Work
0%
Client Retention & Re-Engagement Rate — 2024–2026
9.4×
Average Return on Engagement Investment Across Portfolio
$5.9M
Average Incremental Revenue Lift Per Engagement
13 Mo.
Average Engagement Break-Even Timeline
$47.3M
Total Incremental Revenue Captured — Portfolio 2024–2026

Your quality scores are already
a financial instrument.

CMS1 Partners™ helps IPAs, medical groups, and MSOs convert their quality performance into contract leverage — with measurable, documented results and 20+ years of payer-side and provider-side expertise.

Start Driving Success

No obligation  ·  U.S. Based & National Reach  ·  IPA  ·  Medical Group  ·  MSO

Quality Success and Revenue is no longer a clinical metric. It’s a financial lever — the gap between organizations that understand that distinction and those that don’t is widening every single contract cycle.
CMS has been explicit.

Star Ratings directly determine plan revenue. And plan revenue determines how aggressively — or how reluctantly — your payer sits across the table from you.


What most medical groups and IPAs have not fully internalized is this: your quality performance is your negotiating position.

Create exceptional partnerships
with our guidance!

CMS1Partners.com