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What to look for in ACO healthcare software: A buyer’s guide
Choosing accountable care organization (ACO) healthcare software is often handled as a procurement exercise, but the decision shapes how clearly your organization understands its financial position for years afterward. The quality of that decision is difficult to judge from a vendor demonstration, because most value-based care (VBC) software presents a similar front end: attributed lives, … What to look for in ACO healthcare software: A buyer’s guide
HEDIS MY 2027: Key Changes healthcare organizations need to know
The National Committee for Quality Assurance (NCQA) has announced several upcoming changes to the Healthcare Effectiveness Data and Information Set (HEDIS®) that will influence how organizations measure, report, and improve quality of care.1 For Measurement Year (MY) 2027, these updates reflect emerging clinical priorities, advances in technology, and the healthcare industry’s continued shift toward digital … HEDIS MY 2027: Key Changes healthcare organizations need to know
Modernizing healthcare analytics to deliver faster cost and utilization insights
Cambia Health Solutions (Cambia) serves more than 2 million members through its regional health plans and is guided by a mission to make healthcare easier and lives better. To support that mission, the organization set out to strengthen its analytics foundation with a more scalable, reliable approach to delivering timely, trusted insights for actuarial and … Modernizing healthcare analytics to deliver faster cost and utilization insights
What is risk adjustment software? A guide for healthcare organizations
Risk adjustment depends on accurate data, complete documentation, and consistent workflows. For healthcare organizations managing risk-based contracts, those requirements can become difficult to coordinate across teams, systems, and populations. Claims data may live in one place, clinical data in another, documentation review in a separate workflow, and reporting in static dashboards or spreadsheets. Risk adjustment … What is risk adjustment software? A guide for healthcare organizations
The importance of data selection in AI model training, testing, and deployment
Artificial intelligence is only as good as the data behind it. In healthcare, even small differences in inputs can lead to vastly different outcomes, making data quality and provenance critical to evaluating AI models. This whitepaper introduces the Milliman MedInsight Data Confidence Model, a structured approach built on 25 years of experience matching the right … The importance of data selection in AI model training, testing, and deployment
Signs your organization needs better clinical and claims data integration
Almost no healthcare organization intentionally builds a fragmented data environment. Fragmentation develops through reasonable decisions: an acquired practice arrives with a second EHR instance, a risk-based contract introduces another payer file, a vendor relationship brings in laboratory or pharmacy feeds. Their combined effect is a set of systems describing the same patients and members differently. … Signs your organization needs better clinical and claims data integration
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What to look for in ACO healthcare software: A buyer’s guide
Choosing accountable care organization (ACO) healthcare software is often handled as a procurement exercise, but the decision shapes how clearly your organization understands its financial position for years afterward. The quality of that decision is difficult to judge from a vendor demonstration, because most value-based care (VBC) software presents a similar front end: attributed lives, … What to look for in ACO healthcare software: A buyer’s guide
HEDIS MY 2027: Key Changes healthcare organizations need to know
The National Committee for Quality Assurance (NCQA) has announced several upcoming changes to the Healthcare Effectiveness Data and Information Set (HEDIS®) that will influence how organizations measure, report, and improve quality of care.1 For Measurement Year (MY) 2027, these updates reflect emerging clinical priorities, advances in technology, and the healthcare industry’s continued shift toward digital … HEDIS MY 2027: Key Changes healthcare organizations need to know
Modernizing healthcare analytics to deliver faster cost and utilization insights
Cambia Health Solutions (Cambia) serves more than 2 million members through its regional health plans and is guided by a mission to make healthcare easier and lives better. To support that mission, the organization set out to strengthen its analytics foundation with a more scalable, reliable approach to delivering timely, trusted insights for actuarial and … Modernizing healthcare analytics to deliver faster cost and utilization insights
What is risk adjustment software? A guide for healthcare organizations
Risk adjustment depends on accurate data, complete documentation, and consistent workflows. For healthcare organizations managing risk-based contracts, those requirements can become difficult to coordinate across teams, systems, and populations. Claims data may live in one place, clinical data in another, documentation review in a separate workflow, and reporting in static dashboards or spreadsheets. Risk adjustment … What is risk adjustment software? A guide for healthcare organizations
The importance of data selection in AI model training, testing, and deployment
Artificial intelligence is only as good as the data behind it. In healthcare, even small differences in inputs can lead to vastly different outcomes, making data quality and provenance critical to evaluating AI models. This whitepaper introduces the Milliman MedInsight Data Confidence Model, a structured approach built on 25 years of experience matching the right … The importance of data selection in AI model training, testing, and deployment
Signs your organization needs better clinical and claims data integration
Almost no healthcare organization intentionally builds a fragmented data environment. Fragmentation develops through reasonable decisions: an acquired practice arrives with a second EHR instance, a risk-based contract introduces another payer file, a vendor relationship brings in laboratory or pharmacy feeds. Their combined effect is a set of systems describing the same patients and members differently. … Signs your organization needs better clinical and claims data integration
