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Charting new frontiers with generative AI: A MedInsight journey
In recent years, generative artificial intelligence (Gen AI) has progressed far beyond being an industry buzzword—it’s now a driving force reshaping how organizations collect, analyze, and utilize data for optimizing patient care and organizational strategy. The transformative potential of Gen AI, particularly in the realm of healthcare analytics, cannot be overstated. As healthcare organizations grapple … Charting new frontiers with generative AI: A MedInsight journey
Risk Adjustment Services for MA Plans
Medicare Advantage (MA) plans face challenges in accurately assessing and managing member health risks, especially as regulations and CMS guidelines change. To ensure fair reimbursement and stay competitive, MA plans need strong risk adjustment strategies and precise documentation of Hierarchical Condition Categories (HCCs), since mistakes can lead to compliance issues and lost revenue. They also … Risk Adjustment Services for MA Plans
Advancing pharmacy management: The impact of biologics, biosimilars, GLP-1s, and data-driven insights
Healthcare costs continue to climb with the average per-person expense rising 6.7%—from $7,378 in 2024 to $7,871 in 2025. This increase is being driven primarily by two categories: pharmacy and outpatient facility care. Pharmacy costs alone grew by 9.7%, while outpatient facility care costs have risen by 8.5%. Collectively, these service areas are responsible for … Advancing pharmacy management: The impact of biologics, biosimilars, GLP-1s, and data-driven insights
Measuring how GLP-1 medications impact the total cost of care
Flexible analytics are valuable tools to inform the management of costs and outcomes for therapies such as glucagon-like peptide-1 (GLP-1) drugs, having a significant impact on payer spending and trend. This paper summarizes central themes and provides illustrative examples from Milliman’s GLP-1 Impact Dashboard suite of analytics to facilitate the strategic management of GLP-1-related care. … Measuring how GLP-1 medications impact the total cost of care
Expanding value-based care: The essential role of specialists in long-term success and patient outcomes
Value-based care (VBC) is reshaping the healthcare landscape by focusing on improving patient outcomes while keeping costs under control. Unlike fee-for-service (FFS) reimbursement, this approach prioritizes quality rather than quantity, aiming to reward effective treatments and preventative strategies that can lead to healthier communities and more sustainable healthcare spending. Traditionally, VBC initiatives have zeroed in … Expanding value-based care: The essential role of specialists in long-term success and patient outcomes
Navigating population health with clarity: Dr. Kodama’s expert tips for success in value-based healthcare
The shift toward value-based care (VBC) is transforming how services are delivered, focusing on improving patient outcomes and engagement while reducing costs. Success in this model depends on understanding your population, managing their health proactively, and coordinating care effectively. Meet Dr. Christopher Kodama, Chief Medical Officer at Milliman MedInsight. With a clinical background in pediatric … Navigating population health with clarity: Dr. Kodama’s expert tips for success in value-based healthcare
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Expanding value-based care: The essential role of specialists in long-term success and patient outcomes
Value-based care (VBC) is reshaping the healthcare landscape by focusing on improving patient outcomes while keeping costs under control. Unlike fee-for-service (FFS) reimbursement, this approach prioritizes quality rather than quantity, aiming to reward effective treatments and preventative strategies that can lead to healthier communities and more sustainable healthcare spending. Traditionally, VBC initiatives have zeroed in … Expanding value-based care: The essential role of specialists in long-term success and patient outcomes
Elevate your organization’s AI usage: Gen AI in Healthcare webinar
AI is progressing rapidly, and implementing new technologies is becoming increasingly necessary for organizations looking to increase operational efficiency. At MedInsight, we utilize AI to enhance products and services, protect PHI, and deliver faster, better insights for our clients. However, implementing AI is not a straightforward process, and questions often arise such as how can … Elevate your organization’s AI usage: Gen AI in Healthcare webinar
Simplify Complex Value-Based Care Data with MedInsight’s VBC Contracts Application
Managing value-based care contracts is complex. MedInsight’s VBC Contracts application simplifies the process by turning healthcare data into actionable insights—helping both payers and providers improve outcomes, reduce costs, and boost contract performance. Learn how predictive analytics, financial reconciliation, and integrated data sources can power smarter decisions in value-based care.
Navigating population health with clarity: Dr. Kodama’s expert tips for success in value-based healthcare
The shift toward value-based care (VBC) is transforming how services are delivered, focusing on improving patient outcomes and engagement while reducing costs. Success in this model depends on understanding your population, managing their health proactively, and coordinating care effectively. Meet Dr. Christopher Kodama, Chief Medical Officer at Milliman MedInsight. With a clinical background in pediatric … Navigating population health with clarity: Dr. Kodama’s expert tips for success in value-based healthcare
Milliman MedInsight names Dr. Christopher Kodama as Chief Medical Officer
Seattle, WA – July 31, 2025 – Milliman MedInsight®, a division of Milliman and a leading provider of healthcare data and analytics software, has named Dr. Christopher Kodama as Chief Medical Officer. Dr. Kodama brings more than 25 years of experience in clinical practice, executive leadership, and healthcare innovation to the Milliman MedInsight leadership team. … Milliman MedInsight names Dr. Christopher Kodama as Chief Medical Officer
CMS 2025 RADV audit expansion: Key changes and what they mean to MA plans
In a significant move announced on May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) revealed plans to initiate annual Risk Adjustment Data Validation (RADV) audits for all Medicare Advantage (MA) plans. In this memo, CMS Administrator, Dr. Mehmet Oz, is quoted as saying “We are committed to crushing fraud, waste and abuse … CMS 2025 RADV audit expansion: Key changes and what they mean to MA plans
