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
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Heart failure admissions: Cost implications of potentially avoidable inpatient care
Key Highlights Background› Methodology› Analysis› Conclusion› Download the article Heart failure (HF) represents one of the most pressing cardiovascular health challenges facing the United States (US). According to the CDC, heart failure occurs when the heart cannot pump enough blood and oxygen to meet the body’s needs. Although it is a serious condition, it does … Heart failure admissions: Cost implications of potentially avoidable inpatient care
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Examining trends and impacts of rising cesarean section delivery in nulliparous women
Key Highlights Introduction› Study population and delivery trends› Maternal age and payer mix› Costs and complications› Conclusion› Download the article Childbirth is the leading cause of hospital admissions in the United States, with cesarean deliveries being the most frequently performed surgical procedure.1 Cesarean deliveries are a crucial and life-saving intervention2 but they can also pose … Examining trends and impacts of rising cesarean section delivery in nulliparous women
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Why clinical data aggregation is essential for better healthcare analytics
Clinical data accumulates in many places at once, collecting in electronic health records, laboratory systems, pharmacy platforms, care management tools and claims files, each with its own format and update schedule. The consequences are familiar: two departments run comparable reports and arrive at different figures, and analysts spend their time reconciling records instead of interpreting … Why clinical data aggregation is essential for better healthcare analytics
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When screening becomes waste: Ovarian cancer testing in asymptomatic women
Key Highlights The “Silent Killer” and the Urge to Screen› The Current State of Ovarian Cancer Screening› Key Findings From the Analysis› Conclusion: Turning Insight Into Action› Key Takeaways for Healthcare Leaders› Download the article The “Silent Killer” and the Urge to Screen Ovarian cancer is the deadliest gynecologic cancer and the 10th leading cause … When screening becomes waste: Ovarian cancer testing in asymptomatic women
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Case Study
How Missouri Health Value Collaborative cut reporting time from two days to one hour and tripled its regional coverage.
Missouri Health Value Collaborative (MHVC) is a St. Louis-based nonprofit regional health improvement collaborative that brings together self-insured employers, providers, and payers to improve healthcare quality and affordability across Missouri. Its four-person analytics team produces the population health scorecards, utilization reports, and market share analyses that give self-insured employers a clearer picture of the populations … How Missouri Health Value Collaborative cut reporting time from two days to one hour and tripled its regional coverage.
Case Study
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Under CJR-X, the focus is on both quality and cost: Two former CMS officials on what the earlier bundles reveal
Key Highlights Introduction › Interview › What this means for your hospital › With the CJR-X final rule now released in July 2026, the first mandatory, nationwide episode-based payment model for lower extremity joint replacement is set to begin on January 1, 2028. For most acute care hospitals, participation is now settled and required, and … Under CJR-X, the focus is on both quality and cost: Two former CMS officials on what the earlier bundles reveal
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Mitigating the impact of high-cost claimants: A payer analytics approach to total cost of care
It has long been understood that a relatively small portion of any covered population accounts for a disproportionately large share of healthcare spending. A 2025 study by the Employee Benefit Research Institute (EBRI), which examined 13.1 million individuals with employer-sponsored health coverage in 2022, found that the highest-cost 20% of members were responsible for 84% … Mitigating the impact of high-cost claimants: A payer analytics approach to total cost of care
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Why VBC still fails for mature organizations: What actually separates high performers
Value-based care (VBC) has moved well beyond experimentation. For many healthcare organizations, value-based contracts now represent a significant share of revenue, risk exposure, and strategic focus. The industry has largely resolved the question of whether to participate in these models. What remains unresolved is how to manage them most effectively. Increasingly, a common source of … Why VBC still fails for mature organizations: What actually separates high performers
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CJR-X starts January 2028. The hospitals that win are starting now
CMS has finalized the first nationwide expansion of an episode-based payment model, and by its own account the largest such model in Medicare’s history: a mandatory program covering lower extremity joint replacements (LEJR). It is called CJR-X, short for Comprehensive Care for Joint Replacement Expanded, and it begins January 1, 2028, as an ongoing program … CJR-X starts January 2028. The hospitals that win are starting now
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Case Study
Turn total cost of care strategy into measurable action
Healthcare payers are under growing pressure to reduce costs while managing rising utilization, unit cost, pharmacy spend, and medical expense trends. But analytics alone are not enough. To create measurable impact, health plans need trusted data, actuarial alignment, enterprise governance, and a repeatable process for turning insights into action. In this case study, see how … Turn total cost of care strategy into measurable action
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The decade of full risk starts now: Four workflows separate ACOs ready for it
The conditions for value-based care (VBC) have just shifted, as stronger financial results, improved data usability, and new long-term CMS incentives reshape what it takes for Accountable Care Organizations (ACOs) to compete and succeed. ACOs have had access to Centers for Medicare & Medicaid Services (CMS) claims data for years. What has made the difference … The decade of full risk starts now: Four workflows separate ACOs ready for it
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Healthcare payer analytics: Challenges, findings, and next steps
Health plans are investing heavily in analytics and artificial intelligence (AI) but are they getting the results they need? That was the central question at Milliman MedInsight’s June 18th webinar: Data-Driven Payer Strategies: Survey Insights and Solutions. Presenters Marcos Dachary (Milliman MedInsight Principal, Chief Market Strategist and General Manager of Payer Solutions), Lauren Piacentini (Milliman … Healthcare payer analytics: Challenges, findings, and next steps
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