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From readiness to reality: What TEAM’s first year is really testing
In January 2026, CMS’s Transforming Episode Accountability Model (TEAM) moved from policy to practice. For hospitals in mandatory regions, TEAM is no longer something to prepare for on paper; it is live, operational, and beginning to influence how episode performance is evaluated clinically, financially, and operationally. Many organizations are entering 2026 with a measured posture. … From readiness to reality: What TEAM’s first year is really testing
Medicare Advantage 2026: Breaking down the new risk model and its impact in plain terms
The Centers for Medicare & Medicaid Services (CMS) introduced CMS-HCC Version 28 (V28) in 2024 as the next evolution of Medicare Advantage (MA) risk adjustment. For many organizations, the “new CMS-HCC model” felt more theoretical than operational, something plans were preparing for but not fully experiencing. That changes in 2026, when V28 becomes operational at … Medicare Advantage 2026: Breaking down the new risk model and its impact in plain terms
How CareFirst BlueCross BlueShield modernized analytics to cut cost of care
Health plans are walking a tightrope. On one side, utilization is climbing and breakthrough therapies, while clinically promising, are reshaping cost curves. On the other hand, members, employers, and providers expect more convenience, transparency, and value. The mandate is clear: deliver better outcomes and experiences without sacrificing affordability. Meeting that mandate requires more than more … How CareFirst BlueCross BlueShield modernized analytics to cut cost of care
Physician performance enablement: Engaging providers with actionable insights for ACO success
Many organizations now have access to more data than ever before, yet they often struggle to transform this information into practical actions that lead to real improvements in population health. Physicians play a vital role in this process and should be involved early when turning data into meaningful insights that are practical, effective, and aligned … Physician performance enablement: Engaging providers with actionable insights for ACO success
HIMSS26: From data foundations to operational execution in healthcare AI
The HIMSS Global Health Conference and Exhibition has long served as a signal for where healthcare technology is headed. This year’s conference, attended by more than 24,000 healthcare leaders, reflected an industry that has moved past curiosity and into a more demanding phase of transformation. Artificial intelligence (AI), interoperability, and digital infrastructure remained central topics … HIMSS26: From data foundations to operational execution in healthcare AI
Executive Report: Beyond transformation talk: What value-based care organizations need from analytics
Across organizations of all types and sizes, value-based care leaders describe a common tension. Most say their current technology investments align with clinical and business goals, yet budget constraints, data integration hurdles, and persistent interoperability gaps constrain execution. The Milliman MedInsight executive report explores how value-based care organizations use analytics to address rising financial pressure, … Executive Report: Beyond transformation talk: What value-based care organizations need from analytics
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Advanced Health: Holistic population health improvement integrating claims and clinical data
Oregon-based Advanced Health is a coordinated care organization (CCO) – the state’s version of an accountable care organization (ACO) – that takes an innovative approach to the care of its 26,000 members. Serving two counties where 14-17% of residents live in poverty, according to U.S. Census data, Advanced Health manages a population with complex medical … Advanced Health: Holistic population health improvement integrating claims and clinical data
A survey of provider information in medical claims data
Clean data is critical for analytical work of all kinds, and healthcare claims data is no exception. In this whitepaper published by Milliman MedInsight, Senior Data Scientist Brian Merkey PhD, discusses the relevance of clean data for one narrow element in the healthcare data ecosystem: provider information in medical claims datasets. This work shares the … A survey of provider information in medical claims data
A year in review: The growing role of analytics in value-based care
This past year, the industry has witnessed significant advancements in value-based care (VBC) models. As the industry continues to move away from traditional fee-for-service models, there has been a growing emphasis on population health management, the integration of technology and analytics, and the implementation of collaborative care models. These developments have been instrumental in driving … A year in review: The growing role of analytics in value-based care
Addressing pharmacy drug trends with employer group reporting
According to a new study by the Business Group on Health, over 90% of employers reported concern over high-cost drugs and increasing pharmacy costs. This figure is not surprising when you consider that the average list price increase was nearly $150 per drug in January 2022 and rose to $250 by July 2022. During the … Addressing pharmacy drug trends with employer group reporting
How EHR workflows impact clinician experience, patient care, and profitability
What are your workflow interoperability pain points? Remarkably, 98% of clinicians say their ability to provide the best patient care and receive timely reimbursement is hampered because they can’t easily access patient-specific recommendations. It all comes down to workflow interoperability. EHRs weren’t built to be simple, and clinicians simply don’t have the time at the … How EHR workflows impact clinician experience, patient care, and profitability
MSSP ACOs using Milliman MedInsight achieved over $274M shared savings in 2022 under CMS Medicare Shared Savings Program
SEATTLE, WASH. – Nov. 17, 2023 – Milliman MedInsight, a leading healthcare data and analytics company, is pleased to announce the outstanding achievements of Accountable Care Organizations (ACOs) utilizing the Milliman MedInsight healthcare analytics platform in support of the Medicare Shared Savings Program (MSSP) for the 2022 performance year. Key Highlights of 2022 Performance Results … MSSP ACOs using Milliman MedInsight achieved over $274M shared savings in 2022 under CMS Medicare Shared Savings Program
