Actuarial services
Rating and contract pricing
Claims-driven rates for healthcare contracts, built to be defended
The engagement
Spreadsheets were not built for this.
Healthcare rating is still dominated by manual processes: actuaries pulling claims extracts, building one-off models in spreadsheets, and producing rate recommendations that are stale before they are delivered. The problem is not talent. It is tooling.
How Ariv approaches it
Structure, transparency, auditability.
Ariv's rating engine brings structure to the process. Claims-driven models for specialty sub-capitation, episode-based contracts, case rates, and total cost of care, with the transparency and auditability that actuaries and underwriters demand. Every recommendation traces back to verified claims data.
How we work
- 01
Input
Claims experience
Claims-level cost and utilization for the populations and services being rated.
- 02
Intelligence
Rating models
Sub-capitation, episode, case-rate, and total-cost-of-care models with transparent factors.
- 03
Output
Defensible rates
Rate recommendations that trace back to verified claims data, ready for the negotiation.
Who we work with
Organizations that carry the risk.
- A specialty group pricing sub-capitation
- A provider organization negotiating episode contracts
- An MSO developing case rates across markets