Data-Driven Payer Operations

Intelligence That Drives Strategy

Health plans that compete on data outperform those that don't. From understanding medical cost drivers to predicting member risk and measuring operational efficiency, analytics is the engine of modern health plan management. Hetasalvation builds the analytics infrastructure and BI solutions that make your data a strategic asset.

We combine healthcare domain expertise with modern data engineering and BI development to deliver dashboards and models that executives trust and operations teams use daily.

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Analytics Services

Healthcare Payer Analytics

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Claims & Medical Cost Analytics

Deep claims analytics that identify medical cost drivers, high-cost claimants, utilization trends, and savings opportunities across your membership.

Medical Loss Ratio (MLR) analysis
Unit cost & utilization analysis
High-cost claimant identification
Specialty spend analysis
Trend monitoring & forecasting

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Financial Reporting & FP&A

Financial dashboards and planning analytics — premium revenue, medical costs, administrative expense, and PMPM trend reporting for leadership and the board.

PMPM trend dashboards
Premium vs. medical cost analysis
Product line P&L reporting
Budget vs. actual variance analysis
Actuarial assumption tracking

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Quality & Star Rating Analytics

HEDIS, CAHPS, and Star Rating analytics that track measure performance, identify improvement opportunities, and project Star rating trajectory.

HEDIS measure performance tracking
CAHPS survey analytics
Star rating simulation modeling
Care gap population analysis
Quality bonus revenue forecasting

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Predictive & Risk Analytics

Predictive models that forecast medical costs, identify members likely to develop high-cost conditions, and optimize care management program targeting.

Medical cost prediction models
Risk score forecasting (HCC)
Chronic condition onset prediction
Readmission risk models
Care management ROI modeling

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Healthcare Data Warehouse

Design and build a scalable payer data warehouse — integrating claims, eligibility, clinical, and financial data into a unified analytics platform.

Claims data warehouse design
ETL pipeline development
Member 360 data model
Real-time data ingestion
Self-service analytics enablement

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Executive & Operational Dashboards

Powerful, intuitive dashboards built in Power BI, Tableau, or Looker — giving every stakeholder the data they need to make decisions, on any device.

Executive KPI dashboards
Operations performance dashboards
Network performance dashboards
Member satisfaction reporting
Regulatory compliance dashboards

Analytics & BI