About ClearStars
Clear Insights, 5 Star Outcomes.
ClearStars is a Medicare Advantage Star Ratings analytics and healthcare compliance company. We exist because the people who carry quality work deserve value based care analytics they can defend, delivered while the measurement year is still open.
The gap is not a missing report. It is a missing method.
Quality teams are handed tools that describe the past confidently and the future not at all. By the time a rating is confirmed, the year is closed and nothing can be changed. Meanwhile the analytics team rebuilds the same model every year, breaks it whenever the methodology shifts, and carries the whole thing alone and undocumented.
Both problems have the same root. The method is not visible, so it cannot be trusted, maintained, or improved. A number nobody can reproduce has to be defended by authority rather than evidence, and that is a bad position for the person holding it.
Our mission is to bridge the gap between payer strategy, technical reality, and clinical execution by building the most trusted, deterministic AI and advanced analytics platform for population health and value based care. The vision behind it is a healthcare ecosystem where quality is automatic, data is transparent, and administrative noise never gets in the way of patient care.
What changes
- The quality leader can defend the number upward without needing the analyst in the room.
- The analyst can hand the model to someone else, because the definitions are written down rather than remembered.
- The clinical team gets a gap list tied to a patient in front of them, not a file from last quarter.
- A methodology change becomes a version bump instead of a rebuild.
What we value
Five values, each one a promise.
Our mission is to provide data driven insights and resources that lead to proactive strategies and initiatives, not just to hand off reports and dashboards. These are the five commitments that mission rests on.
Precision is patient care.
A wrong number here is not a typo. It is a member who never gets the call, a gap that closes in January instead of October, a bonus payment that becomes a clawback. So we don't move fast and break things. We move deliberately and get it right, and we show you the math.
Signal over noise.
You already have more data than anyone can read. You don't need another report. You need to know which measures move, which members matter this week, and what to do about it by Friday. We surface only what is impactable and urgent, and we leave the rest quiet.
First, do no harm to the workflow.
The people closing your gaps are clinicians, coordinators, and analysts with a full day before they open our software. If a task takes five clicks where one would do, we have failed. Everything we build fits the way your team already works, or it does not ship.
Radical transparency. The glass box.
Every score, every ranking, every recommendation comes with its logic exposed. You can trace any number back to the measure specification and the record that produced it. The same goes for our pricing, our roadmap, and our mistakes. When we are wrong, you hear it from us first, and fast.
Translate to win.
Quality speaks Stars. Analytics speaks SQL. Clinical speaks care plans. Most vendors pick one language and let the other two guess. We sit at the center of the triangle and make sure strategy, data, and the exam room are describing the same patient. That is how a plan actually earns five stars.
In three words, where the five do not fit
- Precision
- Precision is patient care. Signal over noise.
- Transparency
- First, do no harm to the workflow. Radical transparency.
- Partnership
- Translate to win. Not vendor number forty two.
How we work
The same four moves, whatever you buy from us.
Every product and every engagement follows the same shape: start with the least sensitive data that can answer the question, show the math at each step, and end with something your own team can run. Here is what that looks like, offering by offering.
Product
ClearStarsQI
Star Ratings intelligence on published CMS data. No PHI, no BAA.
- Load the published CMS files. Nothing leaves your systems.
- Model cut point exposure and rank the bubble measures by weighted impact.
- Run scenarios against your target rating, with the computation trail attached.
- Walk into the executive suite with a ranked plan, not a year end surprise.
Product
ClearStarsQI+
Deterministic workflow AI on your member level quality data.
- Execute the business associate agreement. Trust earns the data.
- Land a member level extract on the governed foundation.
- Deterministic math ranks the gaps and traces each one to the claim event.
- Your team works the chase list, with the lineage behind every figure.
Product
ClearStarsLM
The clinical outcomes engine, FHIR first, for providers and value based care.
- Execute the business associate agreement and connect clinical data over FHIR.
- Measures run on real clinical data, with less manual retrieval.
- Insight is ranked by outcome impact and sized to respect clinical time.
- Gaps close inside the measurement year, not after it.
Managed Services
Managed Clinical Analytics
Your analytics team, extended, on our runbooks and a published cadence.
- Map the pipelines, the reporting, and the people who depend on them.
- Take over the movement of quality data and the measure reporting.
- Publish on a cadence, with the methodology attached to every output.
- Hand it back documented, so your team runs it after we are gone.
Managed Services
Provenance First Data Architecture
Five governed tiers, with provenance in the first tier rather than the last.
- Start with a fixed fee assessment that moves no data at all.
- Deliver a current state map and a lineage gap list your CIO can read.
- Build the five governed tiers in order, on top of your existing model.
- Every published rate traces to its source record, specification, and run.
Assessments and Advisory
Clinical Analytics Advisory and Fractional CDO/CAIO
Clinical analytics leadership, sized to your stage, ending in a written plan.
- Diagnose where the analytics function actually stands today.
- Fractional chief data or chief AI officer leadership, sized to your stage.
- A strategy tied to quality and financial outcomes, with HIPAA in the first decision.
- A written plan your team owns, not an ongoing dependency.
Assessments and Advisory
Digital Quality Assessment and Readiness Report
The smallest useful engagement we offer. No PHI, no BAA, one written report.
- Intake without protected health information and without a BAA.
- Test the value sets, the supplemental feeds, and the extract logic.
- Register every gap, with the reason it will break under digital measurement.
- Deliver a sequenced remediation plan you can hand to a board or an auditor.
Assessments and Advisory
Supplemental Data Impact Analysis and ROI Assessment
A per feed answer to whether it is worth keeping, traced to your own records.
- Inventory every supplemental feed and what it costs to keep validated.
- Measure each feed's contribution from your records, not a vendor's lift figure.
- Name the overlap, the total cost, and the audit exposure per feed.
- Keep, fix, or retire, in writing, with the reasoning attached.
Custom Development
Custom Development
Architecture, engineering, and analytics as one engagement, staged and documented.
- Scope it and stage it, so there is a point at which it is demonstrably half done.
- Build on a documented stack your team can hire for.
- Demonstrate each stage before the next one starts.
- Write the runbook as we go, so you operate it without us.
What we are not
The list we expect to be held to.
Every company publishes what it does. This is the other half, and it is more useful when you are deciding whether to trust us.
Not magic.
Our AI is engineering, not a black box. It does not think, it does not feel, and it does not get to be wrong quietly. It is a tool that shows its work, and you can audit it.
Not vendor number forty two.
We do not hand over software and disappear. We document everything, we train your team, and we build so you can take it in-house any time you want. We earn the renewal. We never lock you into it.
Not dashboards.
You have plenty. We are answers: which measures, which members, what to do next, and why.
Not a guarantee.
We do not guarantee ratings we cannot control, and we do not tie a fee to a rating outcome. We influence a number that many hands touch.
Not a hidden method.
If a projection cannot be reproduced from its stated inputs, it is not finished. The method behind the output is published, not gated.
Not a certified measure engine.
We are not a certified measure engine and not an accredited measure vendor, and we will never imply otherwise. The day that changes, this page says so.
A lean team, and a deliberate division of the work.
Bert leads technology, engineering, and product. Pedro leads project management and executive operations, and the two partner on marketing and sales. Naming that split matters at this size: it tells you who owns the thing you are about to ask about.
Bert J. Rico
Founder and Chief Executive Officer
Bert J. Rico is Founder and CEO of ClearStars, a Medicare Advantage Stars analytics and healthcare compliance company. With nearly two decades in healthcare and Medicare Advantage quality analytics, Bert has contributed to three 5 Star CMS contracts, including leading Baylor Scott and White Health Plan to its first ever 5 Star rating. He built the logic behind three NCQA pilot measures using electronic clinical data, two of which are now in the measure set, cut more than $730,000 in annual analytics expense, and engineered work behind a certified quality measure engine at Optum. He is hands on in Snowflake and dbt, builds production AI assisted analytics with deterministic math, and holds a B.S. in Computer Software Engineering, magna cum laude, from Barry University.
Read the full bio →
Pedro Cerrate
Chief Operating Officer and Co-Founder
Pedro Cerrate is COO and Co-Founder of ClearStars, leading project management and executive operations. A decorated U.S. Army noncommissioned officer, Pedro served eight years as an M1 Abrams tank crew leader, rose to Staff Sergeant, and was named Noncommissioned Officer of the Year at Fort Riley. He deployed to Iraq, Jordan, and Kuwait, brought his team through every mission with zero casualties, and earned two Army Commendation Medals and ten Army Achievement Medals. He brings that same discipline, accountability, and people-first leadership to building a healthcare analytics company where clear insights drive 5 star outcomes. Pedro holds a B.S. from Florida International University, is bilingual in English and Spanish, and partners with CEO Bert J. Rico on marketing and sales.
Read the full bio →
Channel partnerships
Two people, extended by two named programs.
A team this size does not pretend to have built everything itself. Where an engagement needs cloud scale or around the clock security operations, we deliver it through a partner we can name, and we say which one.
Program member
Microsoft AI Cloud Partner Program
Our cloud and AI work is delivered inside the Microsoft AI Cloud Partner Program, which is how a team this size stands up a governed foundation for a client on infrastructure they already trust.
Managed security channel partner
Huntress
We are a Huntress channel partner for managed detection and response. When an engagement needs endpoints and identities watched around the clock, that is the partner behind it rather than a promise we improvise.
Operators who have carried this work themselves.
We are advised by people who have sat on the other side of the table: run the plan, owned the clinical outcome, or defended the number to a board. They are named in conversation and in the data room, not here, because that is what we have permission to do.
- A former chief executive of two health plans.
- A former chief medical officer at a health plan.
- A health-system VP of Quality Improvement.
- A senior finance consultant in SaaS.
What we hold today, and what we do not claim.
HIPAA compliant today. See our Trust Center for our security and compliance posture.
Synthetic or population level data only in development and demos. No protected health information is collected on this website. Client derived data stays summary level, and where a client engagement is confidential we do not reference it at all, anonymized or otherwise.
We would rather lose a questionnaire scoring round than imply a certification we have not earned. The Trust Center carries the current posture in detail, and it is the only place we describe it.
Built to WCAG 2.1 AA.
Accessibility is a commitment we make to every reader of this site and every user of the products, not a setting we turn on at build time. Five things we hold ourselves to:
- Body text meets AA contrast. The brand gold is used at display sizes, in fills, and on calls to action with dark text, never as body copy on a light ground.
- Touch targets are at least 44 by 44 pixels.
- Every meaningful image carries alt text, and every input carries a label.
- Meaning is never carried by color alone. It is paired with an icon or text.
- The full site is navigable without a mouse, with a visible focus indicator throughout.
If something on this site does not work for you, write to us and we will fix it. Corrections are published, not absorbed.
See how the Glass Box works.
The methodology behind our projections is public and ungated. It is the fastest way to judge whether our numbers hold up.