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Featured Resources
2024 MSSP success: How Milliman MedInsight VBC solutions help ACOs outperform national averages
Every summer, the Centers for Medicare & Medicaid Services (CMS) announces settlement results for the Medicare Shared Savings Program (MSSP), an update that Accountable Care Organization (ACO) leaders, analysts, and policy experts eagerly anticipate. The MSSP results are more than just numbers in a report; they reflect how well ACOs are delivering value-based care (VBC) … 2024 MSSP success: How Milliman MedInsight VBC solutions help ACOs outperform national averages
Success in value-based care with Milliman MedInsight VBC Platform + ACO Builder
In value-based care (VBC), the strength and effectiveness of the provider network play a major role in determining success under a risk-bearing contract. The right mix of providers can improve outcomes, reduce costs, and help achieve savings targets. The wrong mix can lead to missed quality measures, financial losses, and patient dissatisfaction. Historically, however, network … Success in value-based care with Milliman MedInsight VBC Platform + ACO Builder
Transforming value-based care performance with the MedInsight VBC Platform
Value-based care (VBC) shifts the focus from the quantity of healthcare services delivered to the quality and effectiveness of care provided. In this model, providers are rewarded for improving patient outcomes, enhancing care efficiency, and refining resource use. This shift matters because it aligns incentives with what truly benefits patients: better health, the right amount … Transforming value-based care performance with the MedInsight VBC Platform
Precision is key: How payers can unlock strategic insights from claims and clinical data integration
Today, payers face mounting pressure to deliver better outcomes, control the cost of care, and manage financial risk. Meeting these goals requires more than access to raw data—it demands actionable insights that support strategic, cost-effective decision-making. This is where the integration of clinical and claims data becomes transformative. By bridging the gap between clinical records … Precision is key: How payers can unlock strategic insights from claims and clinical data integration
How healthcare payers can grow their analytic capabilities while staying vigilant against data breach threats
Increasingly scalable, flexible, interoperable, cloud-based platforms supporting sophisticated analytic capabilities have created wide-ranging opportunities and profound insights for healthcare organizations, from improvements in quality of care to cost-saving efficiencies. But the sensitive health care data underlying such promising developments can also leave payer organizations at risk. Healthcare payers handle large volumes of sensitive patient information, … How healthcare payers can grow their analytic capabilities while staying vigilant against data breach threats
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Low-Value Care: A perspective to tackle this global concern
Over the years, wasteful healthcare spending associated with low-value care has become a concern not only in the United States but also around the world. This whitepaper discusses the global nature of this concern and explores an approach to measure and intercept healthcare waste associated with low-value care.
Emergency department super utilizers: More than meets the eye…
In this whitepaper, we will discuss Chronic Condition Hierarchical Groups (CCHGs) as a unique patient-centered methodology for enhancing population health management based on patient and chronic condition information. To understand the prevalence and pattern of super-utilizers, we used the Milliman MedInsight CCHGs on a proprietary dataset (consisting of predominantly commercial health insurance claims) containing approximately … Emergency department super utilizers: More than meets the eye…
Elevating value-based care beyond claims data with EHR insights
Value-based care (VBC) plays a pivotal role in driving quality improvement, enhancing patient satisfaction, and ensuring the sustainability of healthcare systems by delivering better outcomes at lower costs. However, the efficacy of VBC initiatives heavily relies on robust data analytics for planning, monitoring, and evaluating healthcare delivery. This whitepaper will explore opportunities in such analytics … Elevating value-based care beyond claims data with EHR insights
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
