1998
1998
MedInsight History
Our journey of innovation and impact
For over 25 years, Milliman MedInsight’s participation in the world of healthcare analytics has centered on our cutting-edge tools and solutions that are revolutionizing the industry. Milliman MedInsight understands that success in healthcare requires collaboration across the entire ecosystem, from payers and providers to ACOs, purchasers, and consultants. With a strong foundation in actuarial science and extensive expertise in healthcare, Milliman MedInsight is dedicated to empowering payers and providers.
How Milliman MedInsight makes a difference in the market:
Milliman MedInsight Data Confidence Model
Ensure credible, high quality data, with speed to interpretation
Industry-leading Milliman MedInsight Benchmarks
Better evaluate what is driving cost, utilization, and trends within your population
Consultants
Milliman’s long history in actuarial science gives us a leg-up with unbiased research and expertise in risk assessment and healthcare management
Actionable savings
Identify, implement, and measure within a specific timeframe and immediate follow-up steps to act upon
Curated reporting
Tailored and specific reports to our clients needs across all healthcare markets
Data aggregation including EHR
Support better care coordination, health outcomes tracking, and decision-making with comprehensive integrated data
Relevant resources
Whitepaper
Measuring how GLP-1 medications impact the total cost of care
Flexible analytics are valuable tools to inform the management of costs and outcomes for therapies such as glucagon-like peptide-1 (GLP-1) drugs, having a significant impact on payer spending and trend. This paper summarizes central themes and provides illustrative examples from Milliman’s GLP-1 Impact Dashboard suite of analytics to facilitate the strategic management of GLP-1-related care. … Measuring how GLP-1 medications impact the total cost of care
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Expanding value-based care: The essential role of specialists in long-term success and patient outcomes
Value-based care (VBC) is reshaping the healthcare landscape by focusing on improving patient outcomes while keeping costs under control. Unlike fee-for-service (FFS) reimbursement, this approach prioritizes quality rather than quantity, aiming to reward effective treatments and preventative strategies that can lead to healthier communities and more sustainable healthcare spending. Traditionally, VBC initiatives have zeroed in … Expanding value-based care: The essential role of specialists in long-term success and patient outcomes
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Navigating population health with clarity: Dr. Kodama’s expert tips for success in value-based healthcare
The shift toward value-based care (VBC) is transforming how services are delivered, focusing on improving patient outcomes and engagement while reducing costs. Success in this model depends on understanding your population, managing their health proactively, and coordinating care effectively. Meet Dr. Christopher Kodama, Chief Medical Officer at Milliman MedInsight. With a clinical background in pediatric … Navigating population health with clarity: Dr. Kodama’s expert tips for success in value-based healthcare
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CMS 2025 RADV audit expansion: Key changes and what they mean to MA plans
In a significant move announced on May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) revealed plans to initiate annual Risk Adjustment Data Validation (RADV) audits for all Medicare Advantage (MA) plans. In this memo, CMS Administrator, Dr. Mehmet Oz, is quoted as saying “We are committed to crushing fraud, waste and abuse … CMS 2025 RADV audit expansion: Key changes and what they mean to MA plans
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Whitepaper
Measuring the unseen: Differentiation in health system services
Some health systems offer comprehensive services, while others are narrower in scope. Understanding service differentiation gives organizations important strategic insight. In this whitepaper, our goal is to illustrate one approach organizations may leverage in thinking about and quantifying a health system’s differentiation in its various markets.
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Introducing our new eBook: The intersection of clinical data integration and value-based care: Strategies for success
As healthcare pivots towards value-based care (VBC), providers face intricate challenges centered on enhancing patient outcomes while managing costs effectively. This shift demands not only a change in approach but also a sophisticated integration of healthcare data to drive meaningful improvements. At the heart of VBC lies the seamless integration of Electronic Health Record (EHR) … Introducing our new eBook: <em>The intersection of clinical data integration and value-based care: Strategies for success</em>
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eBook
The intersection of clinical data integration and value-based care: Strategies for success
Electronic Health Record (EHR) systems have transformed healthcare by simplifying access to patient data. Their true value emerges when clinical EHR data is integrated with medical claims data, enabling better care coordination, improved quality, and lower costs—key goals of value-based care. Yet, integration remains challenging due to system fragmentation, data silos, inconsistencies, and delays, all … The intersection of clinical data integration and value-based care: Strategies for success
eBook
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Sustaining payer success: Key themes from Becker’s Payer Issues Roundtable
In an era shaped by unpredictable shifts in the healthcare landscape, innovative approaches took center stage at Becker’s Payer Issues Roundtable Spring 2025. For those sessions highlighting data insights through advanced analytics, the necessity of quality data is undeniable. Multiple speakers pointed out that maintaining a competitive advantage depends on proactive planning supported by sophisticated … Sustaining payer success: Key themes from Becker’s Payer Issues Roundtable
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New eBook: Harnessing analytics and AI: A modern guide to risk adjustment
Reliable risk adjustment processes are a critical factor in the success of value-based care, but harnessing the array of data needed to align healthcare costs and provider compensation can be a challenging undertaking. With a growing number of patients enrolled in VBC programs, including the more than 33 million patients enrolled in Medicare Advantage (MA), … New eBook: Harnessing analytics and AI: A modern guide to risk adjustment
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Brochure
Payer Insights
The Milliman MedInsight Payer Insights application provides health plans with an integrated enterprise framework that enhances speed to insight through intuitive dashboards and reports, enabling quick monitoring of cost drivers, quality of care, and utilization trends.
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Navigating value-based care in 2025: How to implement it successfully in your practice
The healthcare industry is changing rapidly, influenced by new regulations, higher consumer expectations, and increasing cost pressures. In addition, the Centers for Medicare & Medicaid Services (CMS) has a big goal: by 2030, all Medicare beneficiaries should be in value-based care (VBC) arrangements. This means we’re seeing a fast shift away from the traditional fee-for-service … Navigating value-based care in 2025: How to implement it successfully in your practice
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eBook
Harnessing analytics and AI: A modern guide to risk adjustment
Value-based care (VBC) models are reshaping the delivery, measurement, and funding of healthcare at an accelerated pace, making precise risk-adjustment processes essential for ensuring that reimbursements and premiums accurately reflect actual care costs. Accurate risk adjustment creates a fair and sustainable link between healthcare costs and provider compensation in risk-sharing arrangements. To succeed requires careful … Harnessing analytics and AI: A modern guide to risk adjustment
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