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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
Top 3 takeaways from NAACOS Spring 2025 Conference
The NAACOS Spring Conference 2025, held April 22-24 in Baltimore, brought together a dynamic mix of healthcare professionals, policymakers, and innovators, dedicated to shaping the future of Accountable Care Organizations (ACOs). This year’s event underscored the need for health systems to address evolving challenges and advance value-based care (VBC) to enhance care quality, improve patient … Top 3 takeaways from NAACOS Spring 2025 Conference
Becker’s Payer Issues Roundtable 2025: Charting Medicare Advantage growth
In April, the Becker’s Payer Issues Roundtable 2025 gathered industry leaders to examine the key challenges facing payers, including the impact of changing regulations and the future of Medicare Advantage (MA). Marcos Dachary, Principal and Chief Market Strategist and General Manager of Payer Solutions at Milliman MedInsight, participated in a panel discussion to explore topics … Becker’s Payer Issues Roundtable 2025: Charting Medicare Advantage growth
Payer analytics in focus: Emerging trends
Last year, our payer articles focused on accelerating digital transformation, increasing transparency and trust in value-based care, and strengthening data foundations. As we move into 2025, we draw on a recent Milliman MedInsight survey of payer customers to offer key insights for payer executives and analytics teams. This article explores the hurdles payers face—from data … Payer analytics in focus: Emerging trends
Next-level risk adjustment: Empowering patient outcomes and financial efficiency
Risk adjustment relies on a long list of health and demographic data points to estimate the cost of patient care across a specific population. Getting it right is critical for ensuring that reimbursements accurately reflect the cost of value-based care. As the data picture becomes more complete, the promise of risk adjustment processes to deliver … Next-level risk adjustment: Empowering patient outcomes and financial efficiency
Building transparency: Best practices for optimizing value-based performance reporting
Transparency plays a crucial role in value-based performance (VBP) reporting. It ensures accountability and trust between health plans and healthcare providers. In a system where outcomes matter, clear reporting fosters better decision-making and collaboration, increasing stakeholders’ commitment to quality care. In this blog post, Milliman MedInsight Marketing Director Sarah Quinn explains the role of technology … Building transparency: Best practices for optimizing value-based performance reporting
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Roses and thorns: The nuanced landscape of healthcare provider data
As the saying goes, all healthcare is local. In the United States at least, this is due in large part to the diverse array of providers and provider organizations across different local healthcare markets. No two provider organizations are the same, and the landscape is constantly changing as mergers and acquisitions, venture capital funding, and … Roses and thorns: The nuanced landscape of healthcare provider data
Analytics in action: Reflecting on 2024 and predicting 2025 trends
The year 2024 has brought significant transformations in healthcare analytics. Groundbreaking technologies such as generative artificial intelligence (Gen AI) and the continued shift towards value-based care (VBC) are rapidly reshaping the healthcare landscape. As 2025 approaches, it’s essential for healthcare organizations to stay abreast of these advancements and adopt effective analytic strategies to strike the … Analytics in action: Reflecting on 2024 and predicting 2025 trends
Transparency and trust in value-based care: financial reporting best practices with BlueKC
Join us for an insightful webinar featuring Kelly Hubka from Blue Cross Blue Shield of Kansas City, as she shares how BlueKC achieved significant success through a commitment to data transparency in value-based healthcare programs. In an industry shifting from volume to value, the importance of clear, accurate financial reporting is undeniable. Kelly will explore … Transparency and trust in value-based care: financial reporting best practices with BlueKC
Unlocking analytics for success in risk contracts: A case study from Genesys PHO
Are you looking to improve your organization’s performance in risk contracts? Join us for an exclusive webinar where Samantha Lewis, Healthcare Business Intelligence & Population Health Analytics Manager at Genesys PHO, shares how her organization achieved millions in savings using advanced data analytics. Learn firsthand from a leading ACO as Samm dives into her experience … Unlocking analytics for success in risk contracts: A case study from Genesys PHO
Achieving analytic maturity: Case studies in data governance, quality, and literacy
In today’s data-driven world, having a strong grasp of data analytics is essential for organizations to leverage their data effectively and drive data-informed decision-making. This article presents a collection of case studies, each highlighting the journey of a different organization towards analytic maturity, facilitated by the expertise of MedInsight’s Strategic Services team. Through the stories … Achieving analytic maturity: Case studies in data governance, quality, and literacy
Understanding the impact of social determinants of health
In recent years, social determinants of health (SDoH) have increasingly become a central topic of discussion among healthcare professionals and policymakers. These determinants encompass a broad range of social and environmental factors that affect individual and community well-being. But understanding their impact is not just about identifying what they are; it is about using data … Understanding the impact of social determinants of health
