Alphiniti manages 5 data types including arch users. Helps you organize, track, and share your work in 1 place for teams and solo users.

For Health Plans & TPAs

Give your clients a reason to stay; and a story to sell.

Continuum RM gives health plans and TPAs early visibility into emerging high-cost claimants and stop-loss risk; helping the self-funded clients you serve reduce healthcare costs, and giving you a concrete, measurable story at every renewal conversation.

See how it works for your book See Employee Benefits Revenue Management

Why this matters right now

$15,786

avg. Medicare payment per unplanned readmission; hospital HRRP exposure (MedPAC)

$4,474

projected savings per employee/year for self-insured employers

$2,035

projected savings per employee/year for fully-insured groups

Estimates based on published benchmarks (MedPAC, Milliman, AHRQ) and internal modeling. Actual results vary by organization. Not a guarantee of savings.

How it works

Integrate

Connects alongside your existing plan administration systems.

See risk early

Real-time stop-loss risk scoring and high-cost claimant alerts across your book.

Show clients results

Give your clients a measurable cost story you can point to at renewal.

Real-time stop-loss risk scoring

See risk exposure across your book as it develops, not after a claim lands.

Emerging high-cost claimant alerts

Identify members trending toward high-cost claims early enough to actually intervene.

Cost reduction for your clients

Help self-funded and fully-insured clients reduce healthcare costs, with the numbers to show it.

Works alongside what you already run

Integrates with your existing plan administration and TPA systems; not a rip-and-replace.

FAQ

Questions brokers ask us

Straight answers on how integration works, what it takes, and what your clients get out of it.

Most plan administration and TPA integrations run alongside your existing systems in a few weeks, not months. Because Continuum RM connects alongside what you already run, there's no rip-and-replace, no data migration project, and no downtime for your members.

No. Continuum RM is designed to work alongside your existing plan administration, claims, and TPA platforms. We pull the signals we need and feed insights back into the tools your team already uses, so your workflows stay intact.

We work with the eligibility, claims, and clinical data you already hold. During onboarding we map your existing fields to our risk models; no new data collection or member outreach is required on your side.

Our models are built on published clinical and cost benchmarks (MedPAC, Milliman, AHRQ) and calibrated against your book. We surface emerging high-cost claimants early enough to intervene, and we show you the confidence level behind every alert so you can act with judgment.

Yes. Continuum RM operates under HIPAA-aligned data handling, with encryption in transit and at rest and role-based access controls. We never sell member data, and access is auditable for every record.

Pricing is structured per the partnership we build together, typically a per-member arrangement that scales with your book. We'll walk through the model in the first conversation so you can see the math before any commitment.

Most TPA reporting tells you what already happened. Continuum RM shows you what's emerging, with real-time stop-loss risk scoring and high-cost claimant alerts across your entire book, so you can intervene before the claim lands, not after.

You get a dedicated partner-team contact from day one, a guided integration plan, and hands-on help mapping your data to our models. We stay engaged through your first renewal cycle so the results show up in the conversation that matters.

Be among the first to bring this to your clients

We're building our first health plan and TPA partnerships now. Tell us about your book and we'll walk through what Continuum RM could look like for your clients.