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Actuarial Analytics

Optimizing growth through deep actuarial, analytic, and healthcare-risk expertise
Our team of actuarial-healthcare experts are embedded across all projects to help clients develop predictive insights and greater granularity to drive improved transparency, clarity, and consistency of business forecasting.

What we do

Market-entrance strategies and new products for payers

We cocreate go-to-market strategies for entering commercial-insurance and government-insurance (for example, Medicaid and Medicare) markets. We also help payers develop new products (for example, high-performance networks).

Improve risk-adjustment programs

We improve the risk-adjustment design of our clients’ ACA and Medicare Advantage programs.

Payer products

We help clients design, price, and improve performance for their commercial- and government-insurance products.

Strategy modeling

Using our analytical skill set, we can model a broad range of topics, including private-exchange strategies, competitive-payer landscapes, and proposal scenarios, for clients to use in internal capability building.

Margin opportunities

We size revenue and cost opportunities that will enable organizations to improve margin and reinvest in growth (for example, by reducing medical cost through payment-integrity initiatives for an insurer and by increasing the operational efficiency of a hospital’s operating room).

Enterprise transformations

We provide enterprise-transformation support (for example, in M&A) to help organizations quickly capture new initiatives.

Regulatory scenarios

We help clients understand and develop perspectives on legislative reform (for example, new proposals on the Patient Protection and Affordable Care Act [ACA] and changes to the Centers for Medicare & Medicaid Services guidance) for their businesses.

Examples of work

Execution road map for a midsize US health insurer

In preparation for an expected request for proposals related to a client’s critical strategic account that represented more than 500,000 administrative-services positions, we conducted an in-depth customer assessment, modeled competitor approaches, and determined win factors.

Evaluation of the third-party-administrator industry for a large US health insurer

We led a comprehensive third-party-administrator-industry assessment, including market sizing, growth projections, competitor and tech-disruptor business models, key customer segments, pricing and profitability architecture, and strategic entry options, for a national health insurer.

Assessment of capital commitments for a major provider system

We developed a sensitivity analysis of a provider’s financial projections across multiple scenarios, which led to a significant reduction of capital commitments over five years while improving the resulting projected asset mix.

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