THIRD HORIZON
AdvisoryActuarialData SolutionsFoundry

Public Sector

State health departments, Medicaid agencies, behavioral health authorities, and federally funded programs

Public-sector leaders carry some of the hardest responsibilities in U.S. health care. A Medicaid rate decision affects millions of people. A behavioral health policy can determine whether someone in crisis receives care. State health departments must balance budget realities against a legislative priority, federal requirements, and growing public frustration with complexity. The work is technical and the stakes are moral.

Third Horizon has partnered with state agencies and federally funded programs through program launches, rate reforms, waiver redesigns, and the operational work that determines whether policy actually reaches the people it's meant to serve.

Advisory Services

Policy is the easy part. Implementation is where most initiatives fail. Our advisors help agency leaders translate legislative intent into programs the market can actually deliver, designing the service model, setting the rates, building the measurable framework, and aligning stakeholders to endure beyond a single administration.

KEY CAPABILITIES
  • Program strategy, design, and implementation
  • Medicaid and Medicare policy and market analysis
  • Value-based care design and payment reform
  • Stakeholder engagement and coalition building
  • Performance measurement and program evaluation
  • Technology-enabled strategy and AI consulting

Actuarial Services & Health Services Research

In government, the math is the contract with the public. Rates have to be actuarially sound. Forecasts have to survive legislative scrutiny. Waivers and demonstrations have to be evaluated with evidence a federal partner will accept. Our actuaries and health services researchers do that work, and have done it in states across the country.

KEY CAPABILITIES
  • Actuarially sound rate development and certification
  • Managed care capitation and risk adjustment
  • Program and waiver financial modeling
  • Health services research and program evaluation
  • Independent actuarial and methodological review

Data Solutions

Agencies sit on more data than almost anyone. They are rarely staffed to turn it into defensible intelligence. Starset Analytics gives public-sector teams a market-grade view of commercial pricing, behavioral health parity, and network adequacy including the benchmarks they need to regulate, negotiate with managed care plans, and answer questions from the legislature, press, and people they serve.

KEY CAPABILITIES
  • Starset Data Service — price transparency data for rate setting, regulatory oversight, and market monitoring
  • Starset Behavioral Health — behavioral health pricing and parity analytics, including the Mental Health Parity Index
  • Starset Clarity — network cost analytics and episode-based benchmarking
  • Custom analytic and advisory support for rate development, waiver evaluation, and program reporting

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If you are a state agency, a Medicaid or behavioral health authority, or a federally funded program looking for analytical partners who can stand behind the numbers, we can help.

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