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The future of managing health costs

Ruby is a healthcare cost management company that helps health plans and employer-sponsored programs reduce the total cost of care using advanced data science, and actuarial expertise.

Ruby transforms complex healthcare data into actionable, savings-driven solutions, enabling organizations to better understand where costs originate, why they occur, and how to intervene effectively

Ruby’s proprietary methodology has been developed, tested and applied by actuaries with several patents pending.

What we do

Data-driven healthcare cost management

Ruby partners with healthcare organizations to identify, implement, and continuously optimize cost-saving opportunities across the full spectrum of care. By combining deep analytics with a consultative approach, Ruby delivers measurable financial impact while improving long-term cost management capabilities.

Ruby’s core capabilities include:

  • Key metrics and benchmarking

    Establishing a clear baseline of healthcare spend and performance, while identifying outliers that represent savings opportunities.

  • Insights to solutions

    Translating data signals into evidence-based, customized interventions that address root causes – not just surface-level symptoms.

  • ROI measurement and optimization

    Treating every solution as an accountable investment, tracked and refined through ongoing ROI measurement.

  • Predictive modeling

    Anticipating future cost drivers and identifying at-risk members to enable proactive intervention.

How we create value

Turning data into measurable savings

Ruby’s approach focuses on moving from insight to action – and proving the value of both.

Clients benefit from:

  • A clear understanding of current cost drivers, using metrics such as PMPM, cost trends, risk scores, claims data, and episode groupings.

  • Root-cause analysis, powered by millions of data points, to uncover the “why” behind rising costs.

  • Customized, evidence-based solutions tailored to each organization’s unique population and risk profile.

  • Continuous performance tracking, including monthly scorecards and solution-level ROI reporting down to the member level.

measurable impact

Proven results in cost reduction

Ruby delivers demonstrated financial results for its clients, including:

~75 million in new savings

Approximately $75 million in new savings in a single year, representing about 2% of total cost of care.

$198 million in total cost of care reductions

$198 million in total cost of care reductions achieved since implementation across client populations.

5.75% savings

Early client results showing 5.75% savings on annual claims spend through targeted interventions.

Predictive and proactive capabilities

Looking ahead to control costs earlier

Ruby’s predictive modeling platform helps healthcare organizations move beyond reactive cost management by forecasting future risk and expense. The platform supports decision-making across areas such as high-cost conditions, surgical episodes, gaps in care, behavioral health, and chronic disease management.

These models help:

  • Identify members at risk before high-cost events occur

  • Enable earlier, more effective interventions

  • Improve cost predictability and long-term affordability

Case Studies

See Ruby's Impact in Action

Case Study

Driving Value in Chronic Condition Management

A health plan partnered with Ruby to gain deeper visibility into their chronic condition management program — uncovering opportunities to improve outcomes and demonstrate measurable ROI.

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Case Study

Streamlining Utilization Management Operations

Ruby's Continuous Measurement Engine gave a utilization management program the data clarity it needed to cut inefficiencies, sharpen decision-making, and optimize operations at scale.

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Case Study

Evaluating a Weight Management Vendor

When a health plan needed an objective view of their weight management vendor's performance, Ruby's measurement platform delivered the evidence-based insights to make a confident decision.

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Who we serve

Health plans and cost-focused healthcare organizations

Ruby primarily supports health plans and organizations responsible for managing population health costs, helping them become true experts in healthcare cost management for their members and clients.

Our Team

Deep expertise, applied practically

Ruby’s team includes actuaries, analysts, data scientists, and statisticians with more than 180 years of combined experience in healthcare analytics and cost reduction. This multidisciplinary expertise enables Ruby to bridge the gap between advanced analytics and real-world operational solutions.

What set’s Ruby apart:

  • Data science with accountability

    Every solution is tracked, measured, and optimized for ROI.

  • Root-cause focus

    Ruby goes beyond benchmarking to uncover why costs occur.

  • Customized, evidence-based solutions

    No one‑size‑fits‑all programs.

  • Commitment to affordability

    Sustainable savings that improve both financial and health outcomes.

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