Commercial teams manage margin pressure, employer expectations, and complex vendor stacks. We’ve talked to commercial leaders about these issues, and they’re exactly what Pareto is built to solve.
Claims payment accuracy by coordinating the complex benefit rules with Medicare.
Member engagement for hard-to-reach segments and key life events that drive meaningful cost management savings.
Fragmented data and reporting across third party administrators (TPAs), pharmacy benefit managers (PBMs), point solutions, and care management.
Operational efficiency while meeting employer SLAs and quarterly reporting cycles.
Hit employer goals faster with less noise and more verified savings.
Pareto navigates the complex regulations of coordinating benefits with Medicare, correcting past mispayments and correcting eligibility and pre-payment coordination.
Generate precision nudges and plan-aligned incentives at onboarding, preventive care, maternity, and care transitions, and steer them to high-value sites and in-network providers while lifting their experience.
Commercial plans win when analytics, execution, and employer storytelling line up. Pareto is built to make sure that happens.
On June 28th, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released the Affordable Care Act (“ACA”) Risk Adjustment Transfer Payment results for the 2018 benefit year. Within days
Pareto targets avoidable utilization and site-of-care shifts with member-friendly outreach and provider-aligned workflows, measuring per member per month, satisfaction signals, and downstream utilization.
Pareto attributes savings at the claim/member level, net out fees and employer-specific totals.
Pareto Intelligence is a healthcare analytics and technology company that helps health plans improve quality, compliance, and financial performance. Our platform spans premium reconciliation, risk analytics, payment integrity, and member engagement—delivering audit-ready insights and measurable outcomes.
For commercial plans, Pareto focuses on claims accuracy and leakage reduction, cost-of-care opportunities (high-cost claimants, site-of-care, avoidable utilization), and member engagement that employers notice—backed by the ParetoIQ suite of solutions for predictive insights and employer-ready reporting.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
