Healthcare Analytical Solutions, Inc

What Healthcare Analytical Solutions, Inc does

Healthcare Analytical Solutions, Inc (HCAS / HCA Solutions) is a privately held actuarial consulting firm headquartered in Bend, Oregon that provides risk management, data analysis, and reporting services to the US healthcare industry. The firm serves three primary customer segments: health plans (including Medicare Advantage, Prescription Drug plans, Medicaid plans, and Coordinated Care Organizations), healthcare providers and Accountable Care Organizations (ACOs) operating under value-based contracts, and employers (including self-funded employer groups and brokers managing medical, prescription drug, and dental benefits). Service offerings span six practice areas: Data Analysis & Reporting, IBNP Estimates & Actuarial Opinions, Medicare Services (MA/PD bid development, risk score projections, audit support), Medicaid Services (capitation rate review, encounter data validation), Employer Services (renewal review, self-funded feasibility analysis), and Provider Services (ACO consulting, value-based contract evaluation).

The firm's analytical work is built on a traditional technology stack of SAS, R, SQL, and Excel for manipulation and summarization of large claims and encounter datasets. Deliverables include actual-to-expected analysis, trend analysis, population stratification, provider profiling, forecasting, statutory and GAAP reserve opinions, and bid development. The company holds no disclosed patents, no proprietary software platform, and no public API.

HCAS operates as a bootstrapped, founder/owner-operated professional services firm with no institutional investors, no disclosed funding history, and no parent company. It runs a sales-led, direct-engagement go-to-market model with enterprise healthcare buyers under quote-based, project-specific pricing. The named leadership team consists of Holly Pfeiffer (Consulting Actuary, ASA, FCA, MAAA; 23 years of experience) and David Tranby (Senior Analyst; 15 years), with no additional management disclosed. The firm serves the United States only and does not claim a global footprint.

Name

Healthcare Analytical Solutions, Inc

Legal name

HealthCare Analytical Solutions, Inc.

Website

https://hcasolutions.com

Company type

Private

Operating status

Operating

Short description

Healthcare Analytical Solutions (HCAS) is a Bend, Oregon-based actuarial consulting firm providing risk management, data analysis, and reporting services to US health plans, providers, and employers, with specialization in Medicare Advantage, Medicaid, and value-based contracting.

Ownership category

akta.pro rank

Product category

Actuarial Consulting Services

NAICS

Management Consulting Services (54161), Other Scientific and Technical Consulting Services (54169)

SIC

Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Value-Based Contracting Analytics (ACO/MSSP/MA, shared savings/risk) (HLACAHAA)

Keywords

• Actuarial consulting services
• Healthcare risk management
• Claims data analysis
• IBNP estimation services
• Medicare bid development

Headquarters

HQ city

Bend

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales

Revenue model

1. Actuarial Consulting Services: Professional consulting services provided to health plans, providers, and employers for healthcare risk management, actuarial analysis, and financial reporting. Revenue is generated through project-based and retainer consulting engagements.

Go-to-market motion1 record

Distribution channels1 record

Core offering

Healthcare Analytical Solutions, Inc is an actuarial consulting firm that provides risk management, actuarial analysis, and reporting services to US health plans, providers, and employers. Core offerings span Medicare Advantage/Prescription Drug bid development, Medicaid plan support, IBNP estimates and actuarial opinions, data analysis and reporting, employer benefit consulting, and provider/ACO value-based contract evaluation.

Product overview

Healthcare Analytical Solutions, Inc (HCAS) is an actuarial consulting company offering a unified portfolio of consulting services rather than a software platform. The core offerings include six interconnected service areas: Data Analysis & Reporting (for cost/utilization monitoring), IBNP Estimates & Actuarial Opinions (claims liability evaluation), Medicare Services (MA/PD bid development and risk management), Medicaid Services (for CCOs and Medicaid plans), Employer Services (for self-funded and fully insured benefit management), and Provider Services (for providers and ACOs managing value-based contracts). These services collectively support identification and management of healthcare financial risks across health plans, providers, and employers.

Differentiator

Problem solved

Functional benefit

Products and services

• Data Analysis & Reporting Collects and compiles client data to develop reports supporting evaluation and monitoring of historical cost and utilization performance, including actual-to-expected analysis, large claim analysis, trend analysis, population stratification, provider profiling, and forecasting. Aimed at health plans, providers, and employers.
• IBNP Estimates & Actuarial Opinions Provides periodic and year-end estimates of claims incurred but not paid (IBNP) to health plans, risk-bearing provider groups, and self-funded employer groups, including year-end actuarial opinions of statutory and GAAP reserves.
• Medicare Services (MA/PD) Supports Medicare Advantage and Prescription Drug plans with risk management and bid development, including MA/PD bid development, desk review support, audit support, Part D risk sharing settlement estimates, feasibility analysis, risk score projections, OOPC model results, and related party reporting.
• Medicaid Services Partners with Medicaid plans, including Coordinated Care Organizations (CCOs), to support evaluation of state-established reimbursement, including review of rating methodologies, validation of encounter data, capitation rates review, risk sharing method evaluation, and risk score review.
• Employer Services Works with brokers and employers to develop solutions for managing financial risk associated with medical, prescription drug, and dental benefits, including renewal review, self-funded feasibility analysis, premium equivalent rate calculation, IBNP estimates, and population composition analysis.
• Provider Services Supports providers and ACOs in evaluating, monitoring, and managing risks under various contractual arrangements with payers, including evaluation of bundled payments, shared savings contracts, capitation contracts, utilization analysis, and ACO consulting services.

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Scale indicators2 records

Recent moves5 records

Expansion highlights2 records

Regional players

• BDO USA (Healthcare): Mid-market professional services firm with a healthcare consulting practice serving smaller health plans, ACOs, and providers — comparable client segment to HCAS though broader in scope and less actuarial-specialized.

Broad incumbents

• Deloitte (Healthcare Actuarial): Big Four consultancy with a substantial health actuarial practice serving Medicare, Medicaid, and commercial plans across the same buyer segments HCAS targets, but with vastly deeper bench and cross-discipline capabilities.
• KPMG (Healthcare): Big Four firm with a healthcare actuarial and risk management practice supporting health plans, providers, and employers — directly comparable buyer segments and overlapping analytical services.
• Mercer: Global consulting firm with deep employer-focused health benefits consulting practice, including actuarial support for self-funded plans, premium equivalent rates, and IBNP estimates — closely mirroring HCAS's Employer Services offering.
• Milliman: Global actuarial and consulting firm with one of the largest US healthcare practices, providing MA bid support, risk adjustment, and provider analytics at significantly greater scale than HCAS.
• Oliver Wyman: Major management consultancy with a dedicated health practice serving health plans, providers, and employers on value-based care strategy and actuarial work — broader portfolio but overlapping actuarial capabilities.
• Aon: Global professional services firm with a large health benefits consulting practice supporting employer self-funded renewals, actuarial analyses, and risk management — overlapping with HCAS's employer-facing services.
• Optum (UnitedHealth Group): Healthcare analytics and consulting arm of UnitedHealth, providing risk adjustment, value-based contract analytics, and actuarial-adjacent services to health plans and providers at vastly greater scale.

Direct peers

• Health Management Associates: Specialized healthcare consulting firm supporting Medicaid plans, health systems, and providers with actuarial, financial, and policy analysis — directly comparable to HCAS's Medicaid and Provider Services practices.
• Wakely Consulting Group: Healthcare-focused actuarial consulting firm serving health plans, providers, and employers with MA/PD bid development, IBNP estimates, and value-based contracting analytics — directly overlapping HCAS's service portfolio across all three client segments.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat2 records

Key risks5 records

Key highlights5 records

Customer concentration

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Healthcare Analytical Solutions, Inc