THIRD HORIZON
AdvisoryActuarialData SolutionsFoundry

Payers

Regional health plans, third-party administrators, and employer-sponsored programs

Competition is national. Expectations are local. The other side of the negotiating table now comes armed with data, and legacy approaches — trended claims, anecdotes, and consultant slides — no longer suffice. Medical costs are rising, network decisions are scrutinized, and every contract and benefit design must stand up from launch through renewal.

Third Horizon gives payers the math, market intelligence, and operational know-how to negotiate more effectively, design sharper strategies, and spend with greater confidence.

Advisory Services

Our advisors have worked inside health plans, not just around them. We help payer leaders design value-based products, rethink network strategy, stand up new lines of business, and translate a cost-containment idea into a workflow a front-line team can actually run.

KEY CAPABILITIES
  • Value-based care design and payment model strategy
  • Network optimization and management
  • Product strategy and benefit design
  • Reimbursement consulting and analytics

Actuarial Services & Health Services Research

Before a rate is filed, before a product is priced, before a contract is signed, someone has to do the math. Our actuaries and health services researchers translate claims data, population insights, regulatory constraints, and uncertainty into numbers leaders can confidently stand behind with boards, regulators, and the market.

KEY CAPABILITIES
  • Rate development and filing support
  • Risk adjustment and population analytics
  • Program and benefit evaluation
  • Independent actuarial validation

Data Solutions

Payers often lack visibility into what competitors pay providers. Starset Analytics changes that by transforming machine-readable disclosures into a clean, validated, and enriched benchmark dataset. The result: a defensible, market-specific view that strengthens every negotiation.

KEY CAPABILITIES
  • Starset Clarity — network cost analytics, competitor rate intelligence, and episode-based cost normalization
  • Starset Data Service — national price transparency data delivered as a subscription feed
  • Starset Behavioral Health — behavioral health pricing and parity analytics
  • Custom analytic and advisory support from actuaries, researchers, and engineers

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If you are a regional health plan, a TPA, or an employer-sponsored program looking for a sharper analytical edge, we can help.

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