Payer Consulting, Health Plan Consulting

Our collaborative partnerships with commercial and public health plans create sustainable, digitally powered, and differentiated business models that keep populations and providers engaged, improve financial resiliency, and nurture growth.

Our Services

Business Optimization link-arrow

We help health plans optimize costs using proven quality management, risk adjustment, and financial modeling techniques, including the design of leading medical loss ratio management transformations.

Data, Analytics & Intelligence link-arrow

We work with payers to leverage data and analytics to pinpoint opportunities for performance improvement and service optimization.

Digital & Technology link-arrow

We help health plans launch cloud-based, interoperable member and provider engagement strategies that differentiate them in the market, increase member acquisition and retention, and improve efficiency.

Strategy & Innovation link-arrow

We work with payers to mitigate risks, improve margin, and grow and optimize their networks via strategic partnerships, joint ventures, health plan formation, and payment model design and innovation.

Our Experts

Our Latest Insights

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Center For Health Insights

The latest on digitally powered, financially resilient, and person-centered healthcare.

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Let Us Guide You

Guidehouse is a global advisory, technology, and managed services firm delivering value to commercial businesses and federal, state, and local governments. Serving industries focused on communities, energy, and infrastructure, healthcare, financial services, and defense and national security, we position clients for AI-led innovation, efficiency, and resilience.

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