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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
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
MA Plan identifies hidden cost drivers and recovers millions through deeper inpatient cost transparency
When a Midwest provider of MA plans was facing mounting costs that its legacy analytics capabilities could not explain, the organization sought help with analyzing utilization costs by facility, market and product, and surfacing trends and insights that could identify cost-saving opportunities. Without the ability to drill down into cost drivers, the unjustifiably high acuity … MA Plan identifies hidden cost drivers and recovers millions through deeper inpatient cost transparency
Research hospital executes a challenging shift to more cost-effective clinical care
When one of the country’s flagship research hospitals sought to shift from high-cost academic work to more cost-effective and sustainable clinical care, the organization began a restructuring designed to improve clinical and financial outcomes in its population of approximately 645,000 at-risk patients, with a focus on the Medicare Shared Savings Program (MSSP) and Medicaid. To … Research hospital executes a challenging shift to more cost-effective clinical care
New report shows how healthcare payers are using analytics and AI to drive impact
Healthcare payers are making big investments in analytics, AI, and digital transformation with the goal of translating data into bottom line efficiencies and improved member experiences. For many payers, however, system integration, staffing, and improved data quality are needed to fully translate analytics investments into the operational gains they are seeking. Those are among the … New report shows how healthcare payers are using analytics and AI to drive impact
Beyond the model: How leading organizations will win under CMS LEAD RFA
A recap of our May 7 webinar If you missed our live session, “How leading organizations will win under CMS LEAD RFA,” don’t worry. My colleague Jonah Broulette, Principal and Consulting Actuary at Milliman, and I walked our audience through what’s actually new in CMS’s LEAD model, how it stacks up against MSSP, and the … Beyond the model: How leading organizations will win under CMS LEAD RFA
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Measuring the unseen: Differentiation in health system services
Some health systems offer comprehensive services, while others are narrower in scope. Understanding service differentiation gives organizations important strategic insight. In this whitepaper, our goal is to illustrate one approach organizations may leverage in thinking about and quantifying a health system’s differentiation in its various markets.
Sustaining payer success: Key themes from Becker’s Payer Issues Roundtable
In an era shaped by unpredictable shifts in the healthcare landscape, innovative approaches took center stage at Becker’s Payer Issues Roundtable Spring 2025. For those sessions highlighting data insights through advanced analytics, the necessity of quality data is undeniable. Multiple speakers pointed out that maintaining a competitive advantage depends on proactive planning supported by sophisticated … Sustaining payer success: Key themes from Becker’s Payer Issues Roundtable
New eBook: Harnessing analytics and AI: A modern guide to risk adjustment
Reliable risk adjustment processes are a critical factor in the success of value-based care, but harnessing the array of data needed to align healthcare costs and provider compensation can be a challenging undertaking. With a growing number of patients enrolled in VBC programs, including the more than 33 million patients enrolled in Medicare Advantage (MA), … New eBook: Harnessing analytics and AI: A modern guide to risk adjustment
Milliman MedInsight unveils expanded Payer Platform capabilities to drive operational excellence
Seattle, WA – June 17, 2025 – Milliman MedInsight® (MedInsight), a leading healthcare data and analytics software provider and division of Milliman, announced today the expansion of its Payer Platform with the launch of the new Payer Insights application. Powered by the Milliman MedInsight Health Cloud, Payer Insights goes beyond traditional analytics by providing health … Milliman MedInsight unveils expanded Payer Platform capabilities to drive operational excellence
Navigating value-based care in 2025: How to implement it successfully in your practice
The healthcare industry is changing rapidly, influenced by new regulations, higher consumer expectations, and increasing cost pressures. In addition, the Centers for Medicare & Medicaid Services (CMS) has a big goal: by 2030, all Medicare beneficiaries should be in value-based care (VBC) arrangements. This means we’re seeing a fast shift away from the traditional fee-for-service … Navigating value-based care in 2025: How to implement it successfully in your practice
Elevate your healthcare data stack: Insights for healthcare leaders
A guide for healthcare executives to ditch outdated “data moving truck” approaches Discover how forward-thinking healthcare organizations are transforming data and insight sharing—without relying on outdated, cumbersome “data moving truck” methods. In this webinar, MedInsight experts reveal modern strategies for secure, agile, and scalable information exchange tailored for healthcare leaders. Join us to learn how … Elevate your healthcare data stack: Insights for healthcare leaders
