Results-as-a-Service for healthcare · HIPAA-compliant

Healthcare data your CFO
can actually use.

We pull your claims, clean the codes, and show you where the money is going by condition, member, and provider. Then we model where it goes next so renewal season stops being a guess.

AI on claims

Pattern detection across ICD, CPT, and Rx

Code-level

Cleaned and normalized at ingest

3 to 10 years

How far ahead we model risk

Platform + partners

Bring your care providers, plug them in

The problem we keep seeing

Why healthcare spend keeps climbing faster than anyone budgets for

It’s not that disease exists. It’s that the financial exposure builds upstream, where standard quarterly reports can’t see it yet.

1

Chronic disease gets more expensive every year you ignore it

Stage progression is measurable. If you can't see it coming, you absorb the cost when it arrives — usually after it's already baked into next year's trend.

2

Big claims rarely come out of nowhere

Most hospitalizations and specialty escalations show up in the claims data months or years before they hit. The signals are there. Most reporting just doesn't look for them.

3

Annual reports tell you what already happened

The standard utilization report answers questions about last year. That's useful. It also won't tell you what next year costs if nothing changes.

4

Pharmacy spend is getting harder to predict

Specialty drugs, GLP-1s, and the specialty pipeline are taking a bigger slice of plan cost every renewal. Without benchmarking, you're negotiating blind.

5

CFOs are absorbing trend on the balance sheet

For self-funded employers and municipalities, healthcare trend lands directly on the books. Planning a budget without forward-looking models means defending it without one too.

6

Rural access gaps quietly become expensive

When intervention gets delayed, manageable conditions turn into high-acuity events. The access problem and the cost problem are the same problem.

The platform · what we build

One analytics core. The same shape whether you're one site or fifty.

Diametrics.ai handles the heavy lifting: claims ingest, pattern detection, financial modeling, secure reporting. The platform stays consistent as your partner network grows.

Claims analysis with ML

AI

We ingest and normalize ICD, CPT, and Rx data, then look for patterns, anomalies, and cost signals across payers.

Diagnostic pattern detection

AI

Models tie claims back to chronic disease categories and the progression pathways that tend to drive cost later.

Predictive risk stratification

AI

HCC scoring at the member level using claims history, SDOH layers, and behavioral signals — not just last year's spend.

Multi-year disease modeling

Track how chronic conditions move through stages across the population over multiple years.

Financial forecasting

AI

Project 3 to 10 year cost exposure under different scenarios, with the model trained on your own claims history.

Stop-loss exposure modeling

Attachment point analysis and high-cost claimant trajectories you can hand to your reinsurer.

Drug spend transparency

NADAC benchmarking, specialty drug visibility, GLP-1 tracking, and Rx cost tied back to the condition driving it.

SDOH layers

Social determinant data joined to geographic risk and access constraints — useful when the cost problem is really an access problem.

Reporting dashboards

Role-based access to scorecards, trend views, cost attribution, and the employer-facing outputs your benefits team actually shares.

API-first integration

Secure connectivity for TPAs, vendors, and downstream systems. Plug it in without a six-month implementation.

API-first, so adding a vendor or TPA later doesn't mean rebuilding anything.

How it fits together

One platform. The right partners around it.

Diametrics.ai is the data and analytics platform. Care delivery stays with the partners best positioned to do it. Data flows between them through a single API surface so the cost picture updates as care actually happens.

The platform

Diametrics.ai

Claims, modeling, and reporting in one place. The same core stays in place whether you're running one site or a statewide network.

  • Claims ingest and code-level normalization
  • Predictive risk and HCC scoring
  • Multi-year cost forecasting
  • Stop-loss exposure modeling
  • Drug spend transparency with NADAC benchmarking
  • Role-based reporting and dashboards
The partners

Care delivery network

We work with the providers and vendors already doing the care. Your existing relationships fit. New ones plug in through the same API.

  • Primary care

    Virtual and in-person primary care groups serving the populations on the platform.

  • Specialty care

    Specialist groups and condition-focused programs that handle escalations identified in the data.

  • Remote monitoring

    Wearables, biometric devices, and monitoring vendors that fill in the data between visits.

  • Care management

    Engagement, follow-up, and care coordination teams that act on the platform’s risk signals.

  • Health tech

    Diagnostic, AI, and digital health vendors that plug in through the same API surface.

One analytics core

The platform normalizes claims, runs the models, and produces the reporting. It stays the same whether you're working with one partner or a dozen.

Partner-friendly by design

Bring your existing care relationships. We integrate with them instead of replacing them. New partners can join without a ground-up rebuild.

Data flows both ways

Partner activity feeds back into the platform so cost attribution and trend models update as care actually happens.

The partners · care delivery

Bring your existing care relationships. We integrate with them.

Diametrics.ai is the data layer. Your care partners are the delivery layer. We don't replace your providers, vendors, or clinical teams — we connect them through one platform so the numbers stay tied to what actually happened.

01

Primary care

Virtual and in-person primary care groups that reach your members where access is thin or inconsistent.

Virtual & clinicChronic managementOngoing engagement
02

Specialty care

Specialist groups and condition-specific programs that pick up the cases the data flags as escalation risk.

Referral pathwaysCondition oversightHigh-acuity follow-up
03

Remote monitoring

Wearable, biometric, and kinematic vendors whose data fills in between visits so you see change without booking another appointment.

WearablesBiometric feedsBetween-visit data
04

Care management

Engagement, follow-up, and care coordination teams that act on the platform’s risk signals before things land in the ER.

EngagementCare coordinationEarly intervention
05

Health tech & AI

Diagnostic, AI, and digital health vendors that plug in through the same API surface — useful when something actually works, not the day after the press release.

API-firstVendor agnosticOptional

Works at any size

Start with one employer or one hospital and one care partner. Add more on either side later. You're not signing up for a statewide rollout to get started.

  • Per employer
  • Per hospital
  • Per region
  • Statewide
  • Multi-state
Self-funded employers

Stop reacting to healthcare cost. Start planning around it.

If you're self-funded, healthcare trend lands on your balance sheet. Traditional benefit design only reacts after the cost is already in. We turn your claims data into forward-looking models so you can see risk early, plan multi-year exposure, and tie care programs to numbers your finance team trusts.

What changes

Last year's utilization reportForward-looking cost models
Vendor-reported outcomesOutcomes verified in your own claims
Reacting at renewalKnowing what renewal looks like
Trend you absorbTrend you can plan against

We're a modeling and reporting platform, not a savings guarantee. Projections are scenario models built from your claims data.

What you get

  • Stop-loss exposure modeling with attachment point analysis
  • Five-year cost projections, with scenarios you can actually compare
  • Risk stratification by condition and cost tier
  • Drug spend transparency, NADAC-benchmarked
  • HCC risk scoring, year over year
  • Budget reporting that holds up in front of a CFO

From line item

to a number you can defend.

Critical access hospitals

A different shape of revenue for rural hospitals

Episodic-only model

  • Volatile revenue
  • Big swings in acuity
  • Unpredictable census
  • Always reacting

With Diametrics + partners

  • Steadier reimbursement
  • Earlier intervention
  • More consistent volume
  • Operating economics that hold up

Big acuity events make revenue lumpy. Steady contact with patients makes it less so. We give CAHs a platform plus partner integrations for monitoring, follow-up, and remote access on top of what they already do.

Less of your revenue depends on a packed ER night. More of it comes from being the place a patient stays in contact with all year.

The point is to stabilize how revenue flows, not to cut needed care. Diametrics.ai provides reporting and tooling — not clinical protocols.

Monitoring between visits

Data keeps coming in when the patient is at home, not just when they walk through the door.

Ongoing patient contact

Coordination tools that keep touchpoints consistent instead of episodic.

Reach without driving everyone in

Partner sites extend care across rural geographies without funneling everything to one location.

Telehealth that fits the workflow

Virtual visits and follow-ups built into the same system as the rest of the care pathway.

Reporting tied to reimbursement

The platform connects what was done to what got paid, so finance and clinical see the same numbers.

More capacity, same headcount

Scale how much care you can deliver without scaling staff one-for-one.

Who we work with

Built for the people who own the cost when it goes wrong.

Self-funded employers

What you're dealing with

  • Trend lands directly on the balance sheet
  • Stop-loss exposure is hard to project forward
  • Specialty and pharmacy spend is a black box

From the platform

Claims normalization, risk stratification, five-year cost forecasts, and stop-loss modeling.

From your partners

Remote monitoring, employer engagement portals, ongoing care coordination.

Municipalities

What you're dealing with

  • Defending the line item to elected officials and the public
  • Trend pressure on a taxpayer-funded plan
  • Not enough analytics horsepower in-house

From the platform

Plan-level financial reporting, condition-level attribution, and outputs that read clearly in council and board meetings.

From your partners

Community access points, telehealth, and workforce support.

Critical access hospitals

What you're dealing with

  • Revenue swings with the next big acuity event
  • Hard to staff up in rural geographies
  • Reimbursement tracks an unpredictable census

From the platform

Claims-tied reporting, multi-year disease modeling, and reimbursement analytics.

From your partners

Monitoring, structured workflows, and remote care extensions.

Rural health networks

What you're dealing with

  • Distance turns small problems into expensive ones
  • Workforce shortages cap reach
  • Sites and systems don't talk to each other

From the platform

SDOH layers, risk scoring, and geographic exposure modeling.

From your partners

Remote primary and specialty care, workforce extension, telehealth.

Care delivery organizations

What you're dealing with

  • Coordinating across sites and payers
  • Measuring performance across spread-out populations
  • Tying finances back to actual care activity

From the platform

API-first integration, secure dashboards, and condition mapping.

From your partners

Condition workflows, lab integration, and care coordination tools.

Financial accountability

The care happened. We make sure the cost line reflects it.

Diametrics.ai is a modeling and reporting platform. We don't give medical advice and we don't guarantee outcomes.

Care to cost, end to end

Tie clinical activity to dollar amounts you can trace from diagnosis to claim line.

Three to ten year exposure

Project long-term cost across your chronic-disease population using your own claims history.

What-if scenarios

Model the dollar impact of potential interventions. We don't project guaranteed savings — that's not honest.

Stop-loss planning

Attachment point analysis and high-cost claimant trajectories you can take into renewal conversations.

CFO and board reporting

Outputs shaped to fit budget cycles and board packets, not just analyst dashboards.

Public-sector documentation

Reports built to hold up under grant requirements, council reviews, and public plan disclosures.

For the record: Diametrics.ai is a modeling and reporting platform. We don't give medical advice and we don't guarantee savings. All projections are scenarios built from your claims data.

Security & compliance

HIPAA-compliant. No shortcuts, no “we’ll fix that later.”

PHI doesn't go through third-party tools that aren't covered. Every deployment is auditable end-to-end. If you want to see the control list, ask.

HIPAA-compliant · Secure cloud · Government-ready

HIPAA-compliant hosting

Cloud environments under signed BAAs and data processing agreements. Nothing else.

AES-256 at rest

Data encrypted at rest with AES-256, keys managed through a dedicated KMS.

TLS in transit

TLS 1.2+ on every network boundary. Nothing crosses the wire in the clear.

Role-based access

Permissions are scoped, so people only see the data their role actually needs.

Immutable audit logs

Every access, export, and config change is logged in a way you can't quietly edit later.

API key rotation

Credentials rotate on a schedule. No long-lived keys sitting in someone's notes.

When you're ready

Build the foundation.
Not another overlay.

Treat healthcare spend like a system you can plan around, not a line item that surprises you every renewal. Same data, different question.

We work with self-funded employers, municipalities, critical access hospitals, and rural health networks. No minimum population.