Health Plan Analytics

Equip your healthcare organization with essential health plan data analytics.

The Challenges Faced by Health Plans

Whether in data analytics, care management, or administration, health plan professionals face distinct challenges. While those in analytics require modern tools for data translation, care managers need a system informing them of members’ clinical statuses now and in the next year. 


Regardless of your role, top-quality technology is crucial to streamlining your job. At Health Cost & Risk Management (HCRM), we provide access to cutting-edge, group and member, health analytics  tailored to your needs so that you can better manage health plans.

How HCRM Can Help?

We aim to simplify the complicated world of health care analytics. We collect data from various claims payers and other sources, validate its accuracy, and translate it into actionable information. 

We also provide a Care Management module that connects to the predictive modeling system, enhancing member engagement and tracking long-term health outcomes. Additionally, our team can provide training, assistance, and more, both on-site and remotely, helping you when and where you need it most. We can assist in creating custom reports and assist in the interpretation of the results of our prediction processing, giving you insight into population health analytics.

Breaking Down Our Health Plan Analytics

At HCRM, we empower health plan organizations with advanced data analytics previously limited to larger companies. No matter your organization’s size, we provide comprehensive annual reports for groups and present summary data,  without revealing protected health information. 


These reports highlight data from your member base, detailing disease prevalence, yearly spending, future medical and pharmacy costs predictions and more. Clients can access our Health Risk Monitor system to clinically stratify a group and identify individuals for intervention, then create custom graphs, enabling outcome reports for improved health and overall cost reductions.

Ready to see how our technology works first-hand? Try a demo of our services today.

The Benefits of HCRM Healthcare Data Analytics

It’s time to empower your organization with actionable insights for improved patient outcomes, lower claims costs and long-term financial security. HCRM’s technology characterizes populations in terms of current and future health risks and cost, offering accurate data analytics to integrate vendors and providers. When you work with us, your organization will receive data pointing you in the right direction to mitigate health risks and financial losses.

Why Choose HCRM?

Accurate Predictions

HCRM’s Predictive Modeling, a healthcare industry leader, utilizes AI technology to create accurate forecasts of member clinical risks and costs.  This allows the user to assess aggregate spending in the next 12 months and identify future high cost members and potential spec losses.  HCRM’s analytics and forecasts permit health plans to formulate programs to address those issues now and avoid future claims.

Measuring Risks in Dollars

Your health plan performance is measured in dollars – are costs going up? How much and why?  Those dollars are a function of each member’s clinical status and behavior.  Translating those risks into dollars and related metrics gives you the ability to forecast future trends and plan programs to help manage member health and avoid costly events and their claims.

Staying Ahead of Rising Costs

Health plan costs continue to increase, often driven by uncontrolled chronic conditions and lifestyle choices.  Focusing on last year’s high-cost members is not necessarily effective because they often spend less in the following year.  HCRM predicts those likely to be high cost next year based on their current clinical condition, allowing you to take action and avoid or reduce the impact on future plan performance.

Streamline Your Health Plan Management with Healthcare Analytics

At HCRM, we aim to assist you with your work, regardless of your role. Our goal is to simplify member information analysis and provide you with accurate information to enhance your effectiveness. Our leading predictive analytics system is the most cost-effective system available and will streamline your daily, monthly, and annual processes while improving member health and reducing costs.

Schedule a Demo Today

Our team is equipped with years of experience and unrivaled data analysis skills. With HCRM’s support, you can see positive health outcomes for your members while mitigating future risks. To find out how this could work for your organization, try a demo or book a call with our experienced team today.