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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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Generative AI in healthcare: Opportunities, challenges, and preparation strategies
Dive into the transformative potential of generative AI in healthcare with MedInsight Product Development Manager Chas Busenburg. In this video, Chas outlines the significant opportunities for efficiency gains through AI, the challenges of adopting disruptive technology, and practical steps for preparation. Learn about the importance of leveraging unique data, collaborating with tech giants like Open … Generative AI in healthcare: Opportunities, challenges, and preparation strategies
Chronic kidney disease: Impact of disease progression on healthcare expenditure
Chronic kidney disease (CKD) is a widespread condition that affects millions of people in the United States, an estimated 37 million people. However, due to its asymptomatic nature in the early stages, many individuals are unaware they have CKD until it reaches an advanced stage. This silent epidemic not only poses a threat to public … Chronic kidney disease: Impact of disease progression on healthcare expenditure
Milliman MedInsight Perspective: Driving digital transformation in health plans
Digital transformation in healthcare is not just about adopting newer, faster technologies. It is about fundamentally changing how healthcare is coordinated and delivered. To advance quality, affordable care, health plans must be able to quickly make sense of the vast amount of data available today. This includes integrating data such as claims, clinical records, and … Milliman MedInsight Perspective: Driving digital transformation in health plans
Milliman MedInsight unveils next generation Payer Platform for advanced healthcare analytics
Seattle, WA – June 4, 2024 – Milliman MedInsight®, a leading healthcare analytics and solutions provider, announced today the expansion of its Payer Platform. This comprehensive enterprise analytic solution harnesses Milliman’s renowned models, methodologies, and data interoperability and introduces expanded analytics capabilities to meet the unique needs of the payer/health insurance market. “We are fully … Milliman MedInsight unveils next generation Payer Platform for advanced healthcare analytics
Accelerate data to insights: the enterprise analytics approach for health plans
Health plans today face an endless variety of challenges, from local and regional competition to the rise of “payviders” and the array of other innovative payment models. It is a complex landscape even before considering the challenges posed by continuously rising costs. In this ebook, we explore the challenges and the opportunities for innovation that … Accelerate data to insights: the enterprise analytics approach for health plans
Diabetes prevalence, cost, and healthcare resource utilization trend in the U.S.
With the prevalence of diabetes in the U.S. forecast to increase 54% by 2030 and patients with diabetes living longer as the result of improved disease management, the healthcare system must grapple with the increased cost of care associated with this condition. Using MedInsight’s CCHG (Chronic Condition Hierarchical Grouper), this study provides a glimpse into … Diabetes prevalence, cost, and healthcare resource utilization trend in the U.S.
