Services

Actuarial expertise, matched to your side of healthcare.

We work across the healthcare economy: health plans, providers, and the investors behind them. Below, what we do organized by who you are, plus the full set of consulting engagements and products underneath.

01

Payers & health plans

Health plans · MA / MCOs · plan startups

From established plans to new MA and MCO entrants, we supply the senior actuarial capacity that keeps a plan priced right, adequately reserved, and competitive.

How we help
1

Interim Head Actuary leadership

Chief-actuary-level oversight of pricing, reserving, and actuarial governance while you build or backfill the role.

2

Pricing, reserving & risk analytics

Rate development, reserve adequacy, and risk analysis that stand up to regulators and auditors.

3

Rate & benefit strategy

Model the economics of benefit designs and network decisions before they hit the market.

02

Hospitals & provider groups

Health systems · specialty & provider groups

We help providers understand and improve the economics of what they deliver, then make sure the reimbursement actually reflects it.

How we help
1

Healthcare economics & margin improvement

Find where revenue leaks and cost hides, quantified with actuarial rigor, then prioritized by impact.

2

Payor / provider contracting

Negotiate and structure contracts so rates reflect the true cost and value of care delivered.

3

Independent Dispute Resolution (IDR)

Recover out-of-network revenue through the federal IDR process under the No Surprises Act, managed end to end.

03

Investors & PE

Private equity · strategic acquirers

We give investors an independent actuarial read on healthcare assets, so the diligence, and the thesis, rest on defensible numbers.

How we help
1

Actuarial & economic due diligence

Independent validation of the assumptions underpinning a target’s financials and projections.

2

Reserve & risk assessment

Test reserve adequacy and quantify the risk exposures that move enterprise value.

3

Value-creation modeling

Model the post-close levers (pricing, contracting, mix) that turn a thesis into realized margin.

Consulting

Senior actuarial judgment, on your terms.

Interim Head Actuary

Chief-actuary-level leadership on an interim basis, guiding the best practices, controls, and analytics of your actuarial department while you hire, restructure, or scale.

Actuarial governance & controls
Pricing and reserving oversight
Team mentoring & process design
Regulator- and board-ready reporting

Healthcare Economics Consulting

Engagements built to increase revenue and reduce cost for healthcare organizations, grounded in actuarial analysis rather than guesswork, and ending in decisions you can act on.

Revenue and margin opportunity analysis
Cost-driver and utilization modeling
Benefit, network & rate economics
Value-based care and risk arrangement design
Products

Productized engagements that run end to end.

Independent Dispute Resolution

Recover out-of-network revenue through the federal IDR process under the No Surprises Act. We position offers, build the evidence, and run eligible disputes to payment.

Eligibility screening & batching
Offer strategy and QPA positioning
Open negotiation and arbitration
Award tracking through to payment
Read the CFO’s guide to IDR →

Payor / Provider Contracting

Negotiate and structure payor–provider contracts so reimbursement reflects the true economics of the care being delivered, not last year’s baseline.

Rate benchmarking & modeling
Contract structure and term strategy
Negotiation support
Ongoing rate and yield monitoring
Talk to Equavis →

Not sure which engagement fits?

Tell us the problem. We’ll point you to the right service, or tell you honestly if it isn’t one we’re best placed to solve.

Schedule a consultation