Learn more about MedInsight in our latest resources
Featured Resources
Under CJR-X, quality decides more than cost: Two former CMS officials on what the earlier bundles reveal
Key Highlights Introduction › Interview › What this means for your hospital › With the CJR-X final rule now released in July 2026, the first mandatory, nationwide episode-based payment model for lower extremity joint replacement is set to begin on January 1, 2028. For most acute care hospitals, participation is now settled and required, and … Under CJR-X, quality decides more than cost: Two former CMS officials on what the earlier bundles reveal
Mitigating the impact of high-cost claimants: A payer analytics approach to total cost of care
It has long been understood that a relatively small portion of any covered population accounts for a disproportionately large share of healthcare spending. A 2025 study by the Employee Benefit Research Institute (EBRI), which examined 13.1 million individuals with employer-sponsored health coverage in 2022, found that the highest-cost 20% of members were responsible for 84% … Mitigating the impact of high-cost claimants: A payer analytics approach to total cost of care
Why VBC still fails for mature organizations: What actually separates high performers
Value-based care (VBC) has moved well beyond experimentation. For many healthcare organizations, value-based contracts now represent a significant share of revenue, risk exposure, and strategic focus. The industry has largely resolved the question of whether to participate in these models. What remains unresolved is how to manage them most effectively. Increasingly, a common source of … Why VBC still fails for mature organizations: What actually separates high performers
CJR-X starts January 2028. The hospitals that win are starting now
CMS has finalized the first nationwide expansion of an episode-based payment model, and by its own account the largest such model in Medicare’s history: a mandatory program covering lower extremity joint replacements (LEJR). It is called CJR-X, short for Comprehensive Care for Joint Replacement Expanded, and it begins January 1, 2028, as an ongoing program … CJR-X starts January 2028. The hospitals that win are starting now
Turn total cost of care strategy into measurable action
Healthcare payers are under growing pressure to reduce costs while managing rising utilization, unit cost, pharmacy spend, and medical expense trends. But analytics alone are not enough. To create measurable impact, health plans need trusted data, actuarial alignment, enterprise governance, and a repeatable process for turning insights into action. In this case study, see how … Turn total cost of care strategy into measurable action
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
Browse our full library of resources
All resources
Data trust: The foundation for informed decision-making
When it comes to getting the most out of your data, there is nothing more critical than the process by which you ensure that it is reliable. Unfortunately, it is not easy to integrate many sources of healthcare data and ensure that it is not only accurate, but that it works together to deliver the … Data trust: The foundation for informed decision-making
Data Confidence Model
In the dynamic landscape of healthcare analytics, accuracy, reliability, and understanding of data are paramount.
Milliman MedInsight announces solution availability in Microsoft Azure Marketplace
Seattle, WA – March 5, 2024 – Milliman MedInsight, a leading provider of healthcare data and analytics, has made its industry-leading Payer and Provider software available on Microsoft Azure. Working with Microsoft in the healthcare industry enables Milliman MedInsight with a greater ability to offer clients powerful solutions that take aim at cost-reduction and enhancing … Milliman MedInsight announces solution availability in Microsoft Azure Marketplace
Value-Based Care: How CFOs can mitigate financial risk with analytics
The imperative for value-based care (VBC) is undeniable. Having access to robust analytics is no longer just a benefit, but an absolute necessity. Escalating U.S. healthcare costs persist as a significant concern for organizations, placing a substantial burden on chief financial officers (CFOs) to address and manage this challenge effectively. To effectively navigate the path … Value-Based Care: How CFOs can mitigate financial risk with analytics
SEHP: Maximizing the power of integrated data with the Innovation Portal
Southeastern Health Partners (SEHP) – a clinically integrated network consisting of four healthcare systems, including 13 hospitals and 3,600 providers – sets its continuous improvement goals high. The Greenville, South Carolina-based organization is already recognized by the Centers for Medicare & Medicaid Services for consistently ranking among the most efficient Accountable Care Organizations. Even so, … SEHP: Maximizing the power of integrated data with the Innovation Portal
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
