CMS Quality Performance Consulting

Better Quality Metrics. More Reimbursement. Higher Star Ratings.

We help hospitals and health systems improve their CMS quality performance — maximizing Medicare reimbursement and driving the star ratings that build lasting public reputation.

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50+ Health Systems Served
15+
Years Experience
$450M+
Revenue Protected
Clinical Quality Advisors — Healthcare and consulting professionals
94.2
CMS VBP Score
▲ +6.8 pts
Star Rating
Improved
3 ★ → 5 ★ in 18 months
$2.4M
Revenue Recovered
Our Services

What We Do

We work directly inside your data and operations — fast, focused, and built around the CMS quality programs that determine your reimbursement and reputation.

Healthcare Strategy & Performance Improvement

We diagnose exactly where your CMS quality scores are falling short and build targeted improvement plans that move the metrics that matter — quickly and operationally.

Revenue Cycle Optimization

Quality performance directly affects what CMS pays you. We identify every reimbursement dollar tied to quality metrics — including VBP bonuses, penalty avoidance, and payer contract leverage.

Analytics & Data Strategy

CMS data is complex. We translate it into clear, prioritized intelligence — showing you which metrics to move, by how much, and what the reimbursement impact will be before you act.

Star Ratings & Public Reputation

CMS star ratings are how the public evaluates your facility. Higher ratings mean stronger reputation, better patient volume, and a competitive edge that compounds over time.

Deep Expertise

Specialists in Every CMS Quality Program That Affects Your Bottom Line

CMS ties reimbursement to quality through multiple distinct programs. We know each one inside out — and how improving one can lift performance across the others.

01
Value-Based Purchasing (VBP)

CMS adjusts every Medicare payment based on your VBP score. We analyze all quality domains — clinical outcomes, safety, patient experience, efficiency — and build the improvement plan that protects your reimbursement.

02
Readmissions & HACRP Penalty Programs

Hospitals lose millions annually to HRRP and HACRP penalties. We identify the root causes driving your penalty exposure and implement targeted interventions that reduce it.

03
CMS Star Ratings

Star ratings are public. They drive patient choice and shape your facility's reputation. We map exactly which metric improvements move your star rating — and prioritize the highest-impact changes first.

CMS VBP Dashboard
94.2
Total Performance Score
▲ +6.8 pts
vs. baseline period
Quality Score Trend (24 months)
+1.8★
Star Gain
−34%
Penalties
$2.4M
Recovered
Clinical Quality Advisors Team
15+
Years of Healthcare
Consulting Excellence
Who We Are

One of the Most Respected Names in Healthcare Quality Consulting

Clinical Quality Advisors works with large health systems and clinics across the country to close the gap between where they are and where their CMS quality metrics say they could be.

Unlike generalist consultants, we move fast, stay focused, and deliver operational results. Every engagement is grounded in real data — and driven by a clear understanding of how quality performance translates to revenue and reputation.

Data Driven
Quality Focused
Partnership
Contact Us

Let's Talk About Your CMS Performance

Tell us about your organization — your current quality scores, pain points, and goals — and we'll show you exactly where the opportunity is.