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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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Q&A: Cost optimization and analytics, a payer’s top priorities
Payers face a multitude of challenges as they navigate an increasingly complex healthcare ecosystem. From improving member engagement to maximizing technology investments, pressures continue to mount. However, one challenge stands out among the rest – the relentless rise in healthcare costs. According to a recent study conducted by EY-Parthenon and KLAS Research, cost management ranks … Q&A: Cost optimization and analytics, a payer’s top priorities
CFIN: Scaling value-based care with a proven data and analytics platform
With a population of over 250,000 lives spanning eight hospitals and nearly two dozen counties, a Northwest-based clinically and financially integrated network (CFIN) wanted to take the next step in its evolution as a pioneering driver of value-based care (VBC). With a business model incorporating partnerships with both commercial and public health plans and a … CFIN: Scaling value-based care with a proven data and analytics platform
Payer strategies for optimizing provider networks
Join us as we delve into the dynamic realm of healthcare payer strategies aimed at optimizing provider networks for peak efficiency. Learn from industry experts about proven strategies, public and private normative data sets, innovative technologies, and best practices that empower payers to streamline and enhance their provider networks. Gain insights into fostering collaboration, improving … Payer strategies for optimizing provider networks
How does clinical data integration drive value-based care? Lessons learned from leading health systems
Join us as we unravel the significance of clinical data integration, drawing insights from leading health systems that have successfully harnessed both claims and clinical data to advance their value-based care priorities. Discover the lessons learned and best practices in leveraging integrated data for informed decision-making, improved patient outcomes, and enhanced value-based care strategies. Whether … How does clinical data integration drive value-based care? Lessons learned from leading health systems
Strategic approaches to social determinants of health: Prioritizing impactful data for population health
Join us as we explore innovative strategies to address social determinants of health (SDoH), emphasizing the prioritization of impactful data for effective population health management. Discover how strategic approaches can enhance healthcare outcomes by addressing the root causes that impact communities. Industry experts will guide you through actionable insights, data-driven solutions, and best practices to … Strategic approaches to social determinants of health: Prioritizing impactful data for population health
Payer market outlook
Join industry experts as they analyze the current landscape and forecast emerging trends that will shape the payer market. Explore key factors influencing payer strategies, regulatory shifts, and technological advancements that are redefining the payer-provider dynamic. Whether you are a payer representative, healthcare professional, or industry enthusiast, this webinar provides a comprehensive overview of the … Payer market outlook
