Managed care organizations, regional health plans, provider-sponsored health plans and third-party administrators

Payers

Third Horizon helps public and private payer leaders design value-based payment models, improve provider networks and establish new lines of business.

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Key Capabilities

How we support payer teams

Advisory Services

Third Horizon advisors have first-hand experience working with health plans. We help payer leaders successfully design and implement alternative payment models, rethink network strategy, and translate cost-containment concepts into workflows.

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

Third Horizon's actuaries and health services researchers translate pricing data, claims histories, population insights, and regulatory constraints into numbers clients can confidently stand behind with partners, regulators, and investment committees.

Rate development and filing support
Pricing and cost trend forecasting
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 contracted rate machine-readable disclosures into a clean, validated, and enriched benchmark dataset. The result: a defensible, market-specific view that strengthens payer competitiveness.

Starset Data ServiceNational price transparency datasets delivered as a subscription feed

Starset OdinAsk questions in plain language, get sourced answers

Starset Rate CompassBehavioral health contract rates, all in one place

Custom Analytic SupportFrom actuaries, researchers, and engineers

Client Story

Growth and State Contracts

Strategic support for a payer expanding operations and state contracts

A payer came to Third Horizon for strategic support in expanding and sustaining operations and securing additional state contracts. We worked alongside them to explore new value-based payment models, strengthen network adequacy, and respond effectively to new state regulations. As a long-term partner, Third Horizon continues to work with the organization to improve outcomes and remain a sustainable, competitive payer.

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