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
eBook
Build or buy? A guide to modernizing healthcare analytics for payers and providers
For modern healthcare organizations, reliable, scalable, and state-of-the-art data analytics capabilities are not optional. They are a foundational business requirement for an industry expected to deliver continual improvements in both quality of care and the cost of providing it. Keeping up with evolving technology and innovation in healthcare can be a challenging exercise, beginning with … Build or buy? A guide to modernizing healthcare analytics for payers and providers
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2024 MSSP success: How Milliman MedInsight VBC solutions help ACOs outperform national averages
Every summer, the Centers for Medicare & Medicaid Services (CMS) announces settlement results for the Medicare Shared Savings Program (MSSP), an update that Accountable Care Organization (ACO) leaders, analysts, and policy experts eagerly anticipate. The MSSP results are more than just numbers in a report; they reflect how well ACOs are delivering value-based care (VBC) … 2024 MSSP success: How Milliman MedInsight VBC solutions help ACOs outperform national averages
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Success in value-based care with Milliman MedInsight VBC Platform + ACO Builder
In value-based care (VBC), the strength and effectiveness of the provider network play a major role in determining success under a risk-bearing contract. The right mix of providers can improve outcomes, reduce costs, and help achieve savings targets. The wrong mix can lead to missed quality measures, financial losses, and patient dissatisfaction. Historically, however, network … Success in value-based care with Milliman MedInsight VBC Platform + ACO Builder
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Transforming value-based care performance with the MedInsight VBC Platform
Value-based care (VBC) shifts the focus from the quantity of healthcare services delivered to the quality and effectiveness of care provided. In this model, providers are rewarded for improving patient outcomes, enhancing care efficiency, and refining resource use. This shift matters because it aligns incentives with what truly benefits patients: better health, the right amount … Transforming value-based care performance with the MedInsight VBC Platform
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Precision is key: How payers can unlock strategic insights from claims and clinical data integration
Today, payers face mounting pressure to deliver better outcomes, control the cost of care, and manage financial risk. Meeting these goals requires more than access to raw data—it demands actionable insights that support strategic, cost-effective decision-making. This is where the integration of clinical and claims data becomes transformative. By bridging the gap between clinical records … Precision is key: How payers can unlock strategic insights from claims and clinical data integration
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How healthcare payers can grow their analytic capabilities while staying vigilant against data breach threats
Increasingly scalable, flexible, interoperable, cloud-based platforms supporting sophisticated analytic capabilities have created wide-ranging opportunities and profound insights for healthcare organizations, from improvements in quality of care to cost-saving efficiencies. But the sensitive health care data underlying such promising developments can also leave payer organizations at risk. Healthcare payers handle large volumes of sensitive patient information, … How healthcare payers can grow their analytic capabilities while staying vigilant against data breach threats
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Optimizing outcomes: Leveraging analytics for provider performance in value-based care
In a recent webinar discussion, Milliman MedInsight and Genesys PHO explored how healthcare organizations can use performance analytics to strengthen value-based care (VBC) initiatives. The panel included Francesca Hammerstrom, General Manager of Value-Based Care at Milliman MedInsight; Dr. Christopher Kodama, Chief Medical Officer at Milliman MedInsight; Samantha Lewis, Director of Healthcare Business and Population Health … Optimizing outcomes: Leveraging analytics for provider performance in value-based care
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Charting new frontiers with generative AI: A MedInsight journey
In recent years, generative artificial intelligence (Gen AI) has progressed far beyond being an industry buzzword—it’s now a driving force reshaping how organizations collect, analyze, and utilize data for optimizing patient care and organizational strategy. The transformative potential of Gen AI, particularly in the realm of healthcare analytics, cannot be overstated. As healthcare organizations grapple … Charting new frontiers with generative AI: A MedInsight journey
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Brochure
Risk Adjustment Services for MA Plans
Medicare Advantage (MA) plans face challenges in accurately assessing and managing member health risks, especially as regulations and CMS guidelines change. To ensure fair reimbursement and stay competitive, MA plans need strong risk adjustment strategies and precise documentation of Hierarchical Condition Categories (HCCs), since mistakes can lead to compliance issues and lost revenue. They also … Risk Adjustment Services for MA Plans
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Advancing pharmacy management: The impact of biologics, biosimilars, GLP-1s, and data-driven insights
Healthcare costs continue to climb with the average per-person expense rising 6.7%—from $7,378 in 2024 to $7,871 in 2025. This increase is being driven primarily by two categories: pharmacy and outpatient facility care. Pharmacy costs alone grew by 9.7%, while outpatient facility care costs have risen by 8.5%. Collectively, these service areas are responsible for … Advancing pharmacy management: The impact of biologics, biosimilars, GLP-1s, and data-driven insights
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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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