Our Services
Comprehensive actuarial and analytics services built for US healthcare payers and providers.
Actuarial Delivery Model
Built for payer and provider teams making high-stakes decisions
HealthcareSystems delivers actuarial and analytics services for Medicare Advantage, ACA, and Medicaid plans and providers. Engagements are led by credentialed actuaries and supported by production-grade analytics workflows.
Core Actuarial & Pricing
Full-cycle actuarial services including Medicare Advantage bid development, ACA rate filings, and Medicaid rate setting.
- MA Bid Development & Certification
- ACA Marketplace Rate Filings
- Medicaid Rate Setting
- Premium Rate Development
- Product & Benefit Design
Risk Adjustment & Coding
End-to-end risk adjustment services covering RAF modeling, HCC analytics, RADV defense, and coding quality.
- Risk Adjustment Modeling
- HCC Analytics
- RADV Audit Support
- Encounter Data Optimization
- Clinical Documentation Improvement
Advanced Analytics & Data Science
Predictive models and production-grade data science to support population health, Stars, and value-based care.
- Population Health & Predictive Analytics
- Claims & Utilization Analytics
- Stars Ratings & Quality
- Value-Based Care Design
- ML & AI-Driven Tools
Strategic & Compliance
Financial forecasting, appointed actuary services, regulatory analysis, and M&A due diligence.
- Financial Forecasting & Budgeting
- Appointed Actuary Services
- Regulatory Impact Assessments
- Provider Network Analytics
- M&A Due Diligence
Flexible Engagements
Annual Risk Adjustment
Ongoing RAF modeling, HCC review, and audit readiness throughout the plan year.
Bid Season
Comprehensive MA bid development and certification for a single bid year.
Stars Optimization
HEDIS/CAHPS analytics, gap closure strategy, and Stars bonus modeling.
Enterprise Retainer
Full-service actuarial and analytics support across all service lines.