In the heavily risk-based environment of healthcare insurance, keeping a continual finger on the pulse of KPIs is critical to maintaining a profitable and growing operation. HMA Solutions is expert in the design/build of end-to-end analytic systems for reserving, rating, forecasting and more.

Performing a range of essential periodic functions.

Our multifaceted solutions enable you to automate the recurring functions at the core of your actuarial and reporting processes. Our ability to integrate analytics from diverse aspects of your operations, including experience/claims and staffing data, results in sophisticated systems that provide information for:

  • Comprehensive IBNR audits and estimates for monthly, quarterly, and yearly reports
  • Risk analysis and categorization for premium deficiency reserves (PDR) to determine specific reserve needs
  • Settlements for risk adjustment and Medicare Part C & D
  • Provision for Adverse Deviation (PFAD) calculations
Reviewing a report
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