Inovalon
About
Inovalon is a cloud-based healthcare software and analytics company that helps healthcare organizations convert large-scale clinical and claims data into actionable insights for quality measurement, risk adjustment, revenue cycle management, and specialty pharmacy operations. It serves health plans (payers), provider systems, specialty pharmacies, and life sciences organizations across the United States. The company is known for its primary source data registry, the MORE2 Registry, which spans o...
Technology Categories
Certifications & Compliance
Details
Headquarters
Bowie, Maryland
Website
inovalon.comFounded
1998
Company size
1001-5000 employees
Offerings
13 active
VenSearch Intelligence
Ideal Customer
- Inovalon's platform is oriented toward large enterprise healthcare organizations rather than small or mid-market entities.
- Its stated customer base includes all of the top 25 U.S. health systems, all of the top 15 U.S. health plans, 12 of the top 15 global pharmaceutical companies, and 3 of the top 10 U.S. specialty pharmacies.
Key Differentiators
- Inovalon's primary stated differentiator is its MORE2 Registry, described as the industry's largest primary-source healthcare dataset, covering more than 300 million unique lives, over 99 billion medical, pharmacy, and lab events, and sourced from more than 160 primary connections across all payer types including Commercial, Medicare Advantage, Managed Medicaid, Duals, and ACA Exchange.
- Unlike competitors who may rely on a single payer type, Inovalon's dataset spans the full payer mix and is longitudinally linked.
Industries Served
- Inovalon serves exclusively within the U.S. healthcare industry, across four primary customer segments: health plans (payers), healthcare providers (acute, post-acute, and ambulatory), specialty and infusion pharmacies, and life sciences organizations including pharmaceutical companies, medical device manufacturers, and clinical researchers.
- The company does not serve financial services, retail, education, government, or other non-healthcare industries.
Service Coverage
- Inovalon operates primarily in the United States, with its headquarters in Bowie, Maryland and additional U.S. offices in Canonsburg, Pennsylvania and Tampa, Florida.
- Its dataset and customer base span all 50 states and Puerto Rico, and it maintains international delivery centers in Hyderabad and Gurugram, India.
Partnerships
- Inovalon has a documented integration partnership with PointClickCare, with multiple solutions available on the PointClickCare Marketplace including Claims Management Pro, Safety Management, and Patient Payment and Statement Management.
- In January 2026, Inovalon announced an API-based bi-directional integration between ScriptMed and AlayaCare's nursing management platform for specialty and infusion pharmacies.
Company Size
- Inovalon was founded in 1998 in Maryland as MedAssurant by Keith Dunleavy, M.D., and rebranded as Inovalon in 2012.
- Estimated annual revenue is approximately $826 million based on third-party data aggregators, though the company does not publicly disclose financials as a private entity.
Ownership
- Inovalon is privately held.
- The company was publicly traded on the Nasdaq under the ticker INOV from April 2015 until November 2021, when it was taken private in an all-cash acquisition valued at approximately $7.3 billion in enterprise value.
Compliance & Certifications
- Inovalon holds HIPAA compliance, HITRUST certification, Payment Card Industry Data Security Standard (PCI DSS) certification, SOC 1 Type 2 and SOC 2 Type 2 attestations, and aligns with NIST frameworks; its compliance documentation is published through its trust center at trust.inovalon.com.
- The company is a CMS Qualified Entity authorized to receive Medicare Fee-for-Service data for all 50 states and the District of Columbia.
Compiled from public sources by VenSearch · Last researched October 16, 2026
Offerings
13 offeringsClaims Management Medicare Pro
Claims Management Medicare Pro is a cloud-based software solution that provides full visibility into the Medicare claims workflow, from EDI submission directly to CMS and DDE system access through real-time status tracking and error flagging. It allows providers to identify and correct Medicare claim errors immediately, reducing resubmissions and accelerating payment. The product offers 12 months of claims history with analytic tracking and smart alerts.
Claims Management Pro
Claims Management Pro is a SaaS-based all-payer claims management solution that automates claim creation, submission, editing, and resubmission for healthcare providers. It provides real-time eligibility checks, claim status tracking, audit and appeals workflow management, and a single dashboard with visibility across all payers including Medicare, Medicaid, and commercial insurers. The product is designed for acute, post-acute, and ambulatory provider organizations.
Clinical Trial Analytics
Clinical Trial Analytics is a suite of tools for life sciences organizations that uses Inovalon's real-world primary source data to support clinical trial planning, site selection, patient recruitment, and follow-up. It includes the Clinical Research Patient Finder (an AI-powered, EMR-integrated tool for pre-screening trial-eligible patients), the Clinical Trial Eligibility Screener, and Medical Record Location services. The solutions are designed to improve trial diversity, reduce enrollment timelines, and support regulatory readiness.
Converged Quality
Converged Quality is a cloud-based quality measurement software solution for health plans that supports HEDIS reporting and Star Ratings performance tracking. It uses predictive analytics to enable early detection of quality measure eligibility and drive timely care interventions. The product has achieved 24 consecutive NCQA HEDIS certifications.
Converged Record Review
Converged Record Review is an AI-powered SaaS solution that uses natural language processing and machine learning to automate medical record reviews for health plan risk adjustment programs. It helps health plans identify which medical records are likely to contain meaningful clinical documentation, reducing unnecessary manual reviews by up to 50%. The solution integrates with Converged Risk to identify and confirm risk-adjustable medical conditions.
Converged Risk
Converged Risk is a risk score accuracy software for health plans that supports prospective and retrospective gap identification to improve risk adjustment documentation and compliance. It provides analytics informed by Inovalon's primary source dataset to help health plans identify persistent, suspected, and potentially over-coded risk gaps. The software also helps reduce audit exposure and supports accurate encounter submissions.
DataStream
DataStream is a data integration product that unifies claims and clinical data to deliver comprehensive, actionable patient insights at the point of care for providers and pharmacists. It aggregates open and closed claims, medication and allergy data, gaps in care, social determinants of health, and other patient information, reducing data noise and administrative burden for care teams. DataStream integrates directly into pharmacy and clinical workflows, including within ScriptMed.
Health Economics and Outcomes Research (HEOR) Analytics
Inovalon's HEOR Analytics solution uses primary source real-world data from over 300 million unique lives to help pharmaceutical and life sciences companies track patient journeys, reveal treatment patterns, and generate real-world evidence. It supports study design, population identification, and evidence generation across the full product development lifecycle. The solution draws on Inovalon's longitudinal dataset and research expertise to meet regulatory and commercial evidence needs.
Payer Solutions (Converged Suite)
Inovalon's Payer Solutions is a comprehensive suite of cloud-based software for health plans covering quality measurement, risk score accuracy, member outreach, value-based care management, and provider enablement. The suite includes Converged Quality, Converged Risk, Converged Outreach, Converged Provider Enablement, Converged Patient Assessment, and Converged Submissions, all built on the Inovalon ONE Platform. It is used by all of the top 15 U.S. health plans.
Provider Solutions
Inovalon's Provider Solutions is a suite of connected software tools for acute, post-acute, and ambulatory healthcare providers, accessible through a single sign-on portal. It covers revenue cycle management functions including eligibility verification, claims management, Medicare claims management, patient registration, and insurance discovery. The suite also includes safety management tools and is used by all of the top 25 U.S. health systems.
Real-World Data and Insights
Inovalon's Real-World Data and Insights offering provides life sciences organizations and researchers access to curated primary source data extracts from the MORE2 Registry, which covers more than 300 million unique lives and 99 billion medical, pharmacy, and lab events across all 50 states. Authorized users can access open and closed claims data, longitudinal patient journey data, and linked datasets combining claims with EHR data and clinical notes. The offering supports health economics and outcomes research, commercial analytics, and real-world evidence generation.
ScriptMed Infusion
ScriptMed Infusion is a cloud-native pharmacy management software solution purpose-built for specialty and home infusion pharmacies. It automates manual tasks, supports nurse scheduling, site-of-care management, billing and reimbursement, and patient engagement for infusion workflows. The platform is designed to improve operational efficiency and provide real-time analytics and interoperability with external partners.
ScriptMed Specialty
ScriptMed Specialty is a cloud-native, end-to-end SaaS platform designed for the operational and clinical needs of specialty pharmacies. It automates workflows across the entire prescription journey, including order management, patient profiling, clinical decision support, billing and reimbursement, and medication adherence monitoring. The platform leverages Inovalon's primary source data and analytics to reduce cost to serve and improve time to therapy.
Considering Inovalon?
Our team will work with you to determine if Inovalon is the right fit for your organization. From research and assessment through procurement negotiation and ongoing vendor management — we handle the entire process at no cost to you.