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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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Building an in-house data analytics platform
Building an in-house data analytics platform is not a simple undertaking. From anticipating the future needs of your organization to understanding how to curate and accurately make use of your data, the challenges can be overwhelming. Learn from Milliman MedInsight’s Senior VP of Client Success, Ryan Andersen, about how you can save years of development … Building an in-house data analytics platform
The pivotal role of EHR integration in value-based care
The journey towards value-based care (VBC) is becoming more dependent on a key capability: the seamless integration of electronic health records (EHRs) with claims data. This clinical integration enables healthcare organizations to gain a more complete understanding of patient care and outcomes, providing the extensive insight needed to propel forward. Alone, neither clinical nor claims … The pivotal role of EHR integration in value-based care
Insights from AHIP 2024: Value-based care, AI, and more
AHIP 2024 in Las Vegas brought together key stakeholders in the health insurance industry, covering the spectrum of critical payer challenges and opportunities. We explored significant insights gained from our participation at AHIP, focusing on topics such as interoperability in healthcare delivery, value-based care, and the integration of artificial intelligence. Embracing modernization through technology One … Insights from AHIP 2024: Value-based care, AI, and more
Enhancing data integrity with MedInsight’s Data Confidence Model
In this video, MedInsight Vice President of Client Success Derrick Johnson describes how MedInsight’s Data Confidence Model works to ensure high-quality, credible data – with rigorous intake processes, careful aggregation of disparate sources, a thorough system of audits and referential integrity checks to ensure accuracy and identify gaps, and ongoing client support.
Data-based healthcare solutions for employer groups
In this video, Lauren Piacentini, MedInsight Director of Payer Analytics, discusses the best practices for presenting data-driven recommendations to employer groups. Discover the importance of creating standardized, operational, and scalable analytic constructs to effectively communicate with clients. Learn how to work with top-performing clients by using analytics to seek out areas for improvement within pockets … Data-based healthcare solutions for employer groups
Unlocking data for value-based care: Insights and innovations
Join Francesca Hammerstrom, MedInsight General Manager of Provider Solutions, as she delves into the transformative approaches MedInsight is taking to enhance value-based care. (VBC) Discover how MedInsight’s new product suite, including VBC Insights, is tailored to support organizations at various stages of their value-based care journey—from beginners to advanced data analytics teams. Whether you’re starting … Unlocking data for value-based care: Insights and innovations
