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What's driving Trend?

Start with a high-level understanding of what parts of healthcare spend are driving trends within a specific organization or book of business.

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Components of Trend

Why the buzz about Stop-Loss?

Claims over $1 Million have increased 45%*

since 2019, according to a recent study.**


Smart Stop-Loss gives you comprehensive monitoring for today and smarter policy design for tomorrow.

Manage stop-loss deductibles and premiums to save millions.


*109 claims per million members in 2019 to 158 in 2022.
**SunLife study from May 2023.

Think about Premiums

Stop-Loss coverage de-risks self-funded employers from catastrophic or unpredictable losses associated with high-cost claimants.  Stop-Loss itself is not medical insurance – it’s a financial and risk management tool.

Annual premiums increase when too many claimants exceed their deductible. Be data-driven to reduce long-term costs.

Smart Stop-Loss uses data to:

  • Monitor an existing policy
  • Actively manage members approaching deductible thresholds
  • See rising risk and projected year-end spend
  • Determine premiums and deductibles that optimize costs


What is Smart Stop-Loss?

Smart Stop-Loss is an Analytic Package for HDMS clients.

See members and amounts, even before they hit a Stop-Loss deductible threshold. See details around:

Stop-Loss claimants

Flags members that meet policy trigger criteria (diagnoses, conditions, specialty Rx, etc.) on a running basis. See running totals.

Projected risk

Shows month-by-month actuals and projections. See who is likely to meet or exceed deductibles and when for accurate planning.

Potential risk

Uncovers rising risk. See who is approaching (configurable) thresholds, like 80% deductible AND projected year-end estimates.

Key features include:


Ingests your existing policy and adapts analytic processing to your contract details

Adaptive reporting

Reports reflect your policy, configured thresholds, and risk definitions

Predictive Models and AI projections

Predicts which members will meet deductibles


Process sophistication accounts for Laser lists and varying deductibles.

What do you do with these insights?

Accurate planning

Increase the accuracy of forecasts, plans, budgets, spend and financial reporting

Optimize plan design

Design across health plan and stop loss policies to optimize costs

Hyper-personalize care

Help members with hyper-personalized care plans and healthcare resources

Set laser lists and deductibles

Stop-Loss policies are highly customized.  Many include laser lists – these contain specific individuals expected as high-cost claimants.  These individuals have a unique (higher) deductible.

Accurate laser lists ultimately keep Stop-Loss premium lower for the rest of the population.

Smart Stop-Loss packages up information for easy decision-making for next year’s laser lists based on existing health profiles and individual costs.

All analytic views produce results that account for each member’s unique deductible amount.

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Smart Stop-Loss Analytics

Who is HDMS?

HDMS at a glance


We’d love to share a little more about our company and our solutions.


Download for more details on what we do and who we serve. Contact us with any additional questions – we’re here to help!



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Useful Documents

Who is HDMS?

Meeting, …tomorrow!

Sharing insights with polish

Need formal reporting, at scale?

Need interactive dashboards with data visualizations?

Need to present analytics alongside original content or commentary?

Learn more

Many times, you need a mix.

Learn more about how you can blend your online content into other deliverable forms so you can share interesting insights with polish.

Useful Documents

Presentations, interactive visualizations, formal reports, and blending these worlds

The power of HDMS Predictive Capabilities

HDMS provides predicitive models, pre-defined segments, model scores, historical predictions and more.


Bring member-level scores and cohorts into a cross-prediction analytic view.

There’s power and sophistication wrapped up in an intuitive user experience – so you can do more than look back on historical trends.

Learn more

Use data to look ahead. Then take action.

HDMS clients – have your team walk you through the latest models.

What do you do next? We’ll make sure your data supports your next steps and actions.


Powerful predictive analytics, easy to implement and use.

SDoH Insights – fast!

How fast to SDoH insights?

So many options, tied directly to YOUR population

SDoH insights – take your analyses one step further.

See how easy it is to look at how social determinants of health influence your population.

Learn more

SDoH insights – so many options, tied directly to YOUR population

Health data - Architected for the future

Keith Wilton, head of product, reflects on the Enlight Architecture

Health “Big Data” is a beast. It’s not as simple as other Big Data. What’s important to think about regarding the architecture of a health “Big Data” platform?  What’s so special Enlight?  Keith Wilton, head of Product at HDMS shares some inside views.


What’s so special about the Enlight architecture?


Listen in…


Health data - Architected for the future

HDMS Enlight Alerts

Create Alerts. You’ll get emails when hot or emerging issues need your attention!

Data's got your back.

Use Enlight Alerts for no surprises.

There’s so much data and so many metrics these days.  Maybe you don’t have time to check in and investigate results everyday.

Do more with data.

Create Alerts in Enlight. Let data tell you when you need to dig in. Use Enlight’s proactive insights to make more time in your day.


Use Alerts for no surprises - Data's got your back.

Export data anytime you need it!

Export data with ease in Enlight.

Health data is complex, but once unlocked, gives us access to deep insights. Share what you see with others at your organization and break through barriers that slow down your transformation.


Do more with data.

Use Enlight’s analytic insights to help define a better path to health for your population.


Export data with ease in Enlight

Health answers and insights in a flash!


KPI Dashboards and easy data access to connected health insights

See a short Enlight video

Health data is complex, but once unlocked, gives us access to deep insights.

See an example of KPI dashboards. Use or configure for customers or plan sponsors.


Do more with data.

Use Enlight’s analytic insights to help define a better path to health for your population.

Areas of analytic innovation

SDoH Analytics

Take a close look at how social determinants influence costs and utilization for your population.

Point Solution Impact

See the value and impact of point solutions. How do they affect total costs and overall health?

DEI and Health Equity

How equitably do plans and networks meet diverse population needs?

Predictive Analytics

Predictive models help you anticipate costs and identify ideal targets for specific actions.


KPI Dashboards and easy data access to connected health insights