Healthcare strategy architects
Clinically led strategy for health plans and the companies that serve them.
Dueringer Advisors architects Stars strategy, HEDIS strategy, and HEDIS medical record review programs for Medicare Advantage, Medicaid, and Dual Eligible plans, and improves accreditation, member engagement, and operational performance. We also help health tech companies, AI vendors, and investors understand what health plans need and how plans buy.
Tina M. Dueringer, BSN, RN, CCM, PCC
CEO and Principal Advisor. Hands-on in every engagement.
Connect on LinkedIn
20+ years
in managed care, from plan operations to advisory
RN and CCM
Registered Nurse and Board-Certified Case Manager leadership
5 lines of business
Medicare Advantage, Medicaid, D-SNP, C-SNP, and Commercial
On the stage
Regular speaker at national Stars, HEDIS, and quality conferences
Our point of view · The DAI Strategy Review
Performance is decided upstream.
Most plans chase Stars and HEDIS late in the measurement year with outreach campaigns and chart chases. By then, most of the result is already set. The real levers sit upstream: in provider contracts, in the data those contracts require, and in the clinical and operational workflows that produce each measure. That is where we start.
01
Contracts
Provider contracts and incentives that require the data and the care your measures depend on.
02
Data
Supplemental, ECDS, and medical record data captured once, cleanly, and on time.
03
Workflows
Clinical and operational workflows that close gaps as part of the daily work, not as a year-end campaign.
04
Measures
Stars and HEDIS results that hold year over year, not only after a fourth-quarter push.
What we do
Strategy built on clinical and operational judgment
Stars and HEDIS strategy
Stars strategy, HEDIS strategy, HEDIS medical record review (MRR), and HEDIS data.
Learn moreClinical programs and accreditation
Clinical program development and NCQA or URAC accreditation.
Learn moreVendors and investors
Vendor go-to-market, PE clinical due diligence, and investor clinical advisory.
Learn moreCompliance and clinical operations
Compliance, appeals and grievances, care management, and UM.
Learn moreOperations, engagement, and network
Operational excellence, member engagement, and provider contracting and network.
Learn moreWho we serve
One perspective, four kinds of clients
Health plans
MA, Medicaid, D-SNP, C-SNP, and Commercial plans that need quality, accreditation, and care model results.
Health care vendors
Vendors that serve health plans and need their programs to meet plan, NCQA, and CMS expectations.
Health tech and AI
Companies that need to know how plans evaluate, buy, and govern their products.
Private equity and investors
Clinical and operational diligence on payer-facing companies before you commit capital.
Investor servicesHow we are different
The judgment of a clinician. The experience of an operator.
01
Clinically led
Our work starts from clinical practice. We review care management, UM, and quality programs the way a nurse and case manager would, not only the way an analyst would.
02
Built by operators
We have experience with D-SNP implementations and built a payer and provider joint venture, so we understand provider contracting and networks from both sides. Our recommendations come from running the work, not observing it.
03
Senior-led, every time
Our CEO is hands-on in every engagement. You will not be handed off to a junior team after the pitch.
04
A national partner network
We partner with leading firms across the country to bring you the most experienced team for each engagement.
About our partnersHow we typically help
Situations we are brought in for
Client work is confidential. We do not name clients or publish engagement details, and we protect your information the same way.
Stars strategy
Your Star Rating is at risk or stuck below target
We build a measure-by-measure Stars strategy tied to your operations, budget, and timeline.
HEDIS strategy
HEDIS rates stay flat despite more outreach
We build a HEDIS strategy that finds the operational causes and focuses effort on the measures with the most room to move.
HEDIS data challenges
Supplemental, ECDS, or provider data is incomplete
We fix data capture, provider contract data requirements, and reporting workflows.
HEDIS medical record review
Medical record review season is coming, and the program is not ready
We design the MRR program: chase strategy, abstraction workflows, over-read and quality checks, and vendor oversight.
Clinical program development
A clinical program needs to be built or rebuilt
We design programs that meet CMS, state, and NCQA requirements and work for members and staff.
Accreditation
NCQA or URAC survey, renewal, or corrective action is coming
We assess against current standards, close the gaps, and prepare your team for survey.
Vendor go-to-market
A vendor is moving into a new line of business
We show how MA, Medicaid, D-SNP, and Commercial buyers differ, and adjust your positioning, evidence, and pricing.
PE clinical due diligence
A deal needs clinical diligence before close
We test the target's clinical programs, quality claims, and regulatory exposure.
Investor clinical advisory
Investors need a clinical perspective after the deal
We advise investors and portfolio companies on clinical strategy, risk, and health plan market fit.
Compliance
Audit findings or new requirements need a response
We interpret the requirements and help you build compliant policies, workflows, and oversight.
A&G, care management, and UM
Clinical operations are missing timeliness or quality targets
We review appeals and grievances, care management, and UM workflows, documentation, and decisions, then redesign what breaks.
Operational excellence
Operations are slow, costly, or inconsistent
We find the breakdowns and redesign workflows, metrics, and accountability.
Member engagement
Outreach volume is up, but outcomes are not
We design engagement that changes member behavior and moves measures.
Provider contracting and network
Provider contracts and networks are not supporting quality goals
We align contract terms, incentives, and network strategy with your quality and data needs.
Leadership development
Clinical and quality leaders need to grow into bigger roles
We develop leaders so they can run programs, teams, and change with confidence.
Organization restructuring
The clinical or quality organization needs a new structure
We redesign structure, roles, and accountability so the work gets done and stays done.
Success
Our best work is under NDA. Here is what we can tell you.
Our clients trust us with their hardest problems because we keep their names and their numbers private. So we let our track record and our standards speak instead.
How we define success
01
Effort goes where the rate can actually change, not where the noise is loudest.
02
Files, policies, and people are ready before the surveyor asks.
03
Vendors and investors walk in speaking the language of the plan's clinical and quality leaders.
04
If your team needs us to keep it going, we did not finish the job.
Track record
a payer and provider joint venture in Wisconsin
experience with D-SNP implementations in California
at RISE West and the RISE Special Needs Plan Leadership Summit
as a speaker on Stars, HEDIS, and quality
Recently on stage
The HEDIS Strategy Not Discussed
RISE HEDIS and Quality Improvement Summit, Baltimore, November 2026. With Dwight Pattison, QPAdvantage.
Tina and Dwight presented on provider contracts, enforcement, and the shift to digital quality measures. Many plans in the room said their provider contracts are not ready.
More on speakingUpcoming
Dec 14 to 16, 2026 · Scottsdale
RISE Star Ratings Master Class
Data Differences, Measure Specifications, and the D-SNP Landscape
Event websiteInsights
What plans are asking us right now
HEDIS · Coming soon
Your provider contracts are your HEDIS strategy
Why measure performance stalls when contracts do not require the data, and what to change before digital measures arrive.
AI oversight · Coming soon
Vet AI vendors before you sign, not after
What delegated oversight should look like when an AI vendor touches care management or UM.
Industry data · Coming soon
Health plan ecosystem job losses: quarterly tracker
DAI's verified tally of workforce reductions across plans and plan vendors, updated each quarter.