Specialist
Former SVP at Inovalon Holdings Inc
Agenda
- Key trends and developments in the healthcare data and analytics market
- Inovalon's relative end market exposure and runway left for further growth and penetration
- Competitive positioning of major players surrounding Inovalon, including Ciox-Datavant, Optum and others
- External threat of payers building out their own risk adjustment services and realities of running it
- Outlook for H2 2023 and beyond, regulatory environment and strategic realignment
Questions
1.
What are some of the major trends and developments you’ve been following in the healthcare data analytics and solutions market over the past year or so that might better inform our discussion on Inovalon?
2.
How would you break out Inovalon’s core healthcare IT solutions suite and the value proposition across segments? I understand that risk adjustment solutions have been a core revenue driver historically, but how do quality solutions, pharmacy, DataStream and RCM [revenue cycle management] stack up, comparatively?
3.
Which customer end markets are you more optimistic or pessimistic on for continued growth runway and penetration? Essentially, how would you compare the untapped opportunity across payer, provider, pharmacy and life sciences?
4.
What do you think is Inovalon’s strategy to build out its life sciences footprint? How large a piece of the business could that vertical eventually be, perhaps comparing it to the legacy payer vertical?
5.
What are your thoughts on the increasing trend of payers insourcing analytics services and how has Inovalon had to pivot its business to adapt to that threat? What’s the broader strategy behind the Inovalon One platform and its encompassing applications to drive value for payers?
6.
How do you assess Inovalon’s competitive positioning against other point solutions such as Ciox-Datavant – two companies that merged – Cotiviti, Optum and others across solutions segments and data silos? What are some key areas of differentiation in terms of strategic focus, tech capabilities, market share and so on?
7.
How does Inovalon go about customising its payer solutions suite in order to match certain needs of customers from MA [Medicare Advantage] populations? How well has the company done in terms of personalising its offerings for specialised coding and analytical operations? Could you lay out an example or use case here?
8.
What initiatives has Inovalon pursued in order to gather large swaths of data on patient populations? What portion of this do you think comes from HRAs [home risk assessments] vs chart collection vs other avenues? It’s my understanding that having the most robust data assets or depth of data on patient populations is going to be a differentiator, so how is the company looking to expand that scope and capture data through HRAs and other means?
9.
How differentiated is the patient healthcare data Inovalon possesses, perhaps from a depth, quality or reliability perspective?
10.
How do you assess Inovalon’s efforts to increase its revenue out of existing customers? Where are some of the attractive opportunities to cross- or upsell existing accounts to enhance average revenue per client?
11.
How sticky have Inovalon’s contracts been historically? To what extent does the company’s wide breadth of solutions and data quality make it more competitive for deals coming up for renewal?
12.
What are your thoughts on the launch of Inovalon’s Converged Provider Enablement platform in March 2023? I read online that, “The latest version of this cloud-based SaaS product empowers health plans, ‘payviders’ and other value-based healthcare organisations to coordinate complex and disparate combinations of both industry-standard quality and risk goals, as well as highly customised initiatives across large provider systems at the point of care.” How much of a game-changer could this be for Inovalon as it looks to capitalise on the broader shift to a value-based care system?
13.
Could you discuss how Inovalon is using AI to better understand patient risk profiles, disease history, treatment efficacy and so on? What might be a nice use case to help us understand the value-add here?
14.
What are your thoughts around CMS [Centers for Medicare & Medicaid Services] cracking down on miscoding patient risk scores and risk adjustment factor coding on HRAs more broadly? What are the industry-wide implications for large MA players becoming increasingly scrutinised, as well as some of the risk adjustment vendors such as Inovalon?
15.
What are some of the major strategic or operational changes that you’ve observed at Inovalon since being taken private in 2021? How does private investor ownership impact capital deployment, restructuring or overall strategy? You noted the software expertise of Nordic.
16.
Where do you see gaps or weaknesses in Inovalon’s current suite of solutions, and how might the company look to plug these, either organically or via strategic M&A?
17.
How do you asses Inovalon’s efforts to expand margins via cost-cutting or operational efficiencies? I understand the company opened an office in India for product engineering and IT. Could you discuss its offshoring strategy and any other leverage it’s pulling to cut out duplicative or excess costs?
18.
Why do you think companies such as Cotiviti, which is more of a pure-play risk adjustment player, or even Change Healthcare, which plays in RCM services, garnered significantly higher valuations at liquidity events and IPOs than a one-stop-shop such as Inovalon?
19.
What’s your outlook for Inovalon’s business over the next 2-3 years? We’ve noted the company was purchased by a private investor in 2021 for USD 7.3bn. What do you think the strategic exit opportunities look like? Who might be a likely acquirer in the event of a sale, perhaps thinking about payers, private investors or competitors?
20.
Is there anything we haven’t mentioned that might be important to highlight when thinking about Inovalon?
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