The ability to assimiilate and mine billions of pieces of data is no longer a luxury. It’s a necessity to mitigate risk and maintain competitive advantage. At HMA Solutions, our strength lies in streamlining massive data warehouses into workable subsets — using mathematical and statistical principles to create customized solutions.
Powerful tools to drive better decision-making:
Reserving and corporate actuarial functions.
In the midst of a continually evolving environment of markets and exchanges, healthcare insurers and providers need to improve performance and profitability across multiple facets of their operations. HMA Solutions has the wherewithal to apply predictive analytics to the key areas affecting each individual client. Examples of benefits we can provide include:
- Rating tools that leverage experience data from the client’s own operation and/or those of competing entities
- Risk adjustment algorithms that identify coding discrepancies in the client’s claim management database to avoid substantial revenue loss
- Fee assessment models that utilize CPT or 343 codes to compare current and/or projected fee levels to comparable fee levels set by Medicare