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What is risk adjustment software? A guide for healthcare organizations
Risk adjustment depends on accurate data, complete documentation, and consistent workflows. For healthcare organizations managing risk-based contracts, those requirements can become difficult to coordinate across teams, systems, and populations. Claims data may live in one place, clinical data in another, documentation review in a separate workflow, and reporting in static dashboards or spreadsheets. Risk adjustment … What is risk adjustment software? A guide for healthcare organizations
The importance of data selection in AI model training, testing, and deployment
Artificial intelligence is only as good as the data behind it. In healthcare, even small differences in inputs can lead to vastly different outcomes, making data quality and provenance critical to evaluating AI models. This whitepaper introduces the Milliman MedInsight Data Confidence Model, a structured approach built on 25 years of experience matching the right … The importance of data selection in AI model training, testing, and deployment
Signs your organization needs better clinical and claims data integration
Almost no healthcare organization intentionally builds a fragmented data environment. Fragmentation develops through reasonable decisions: an acquired practice arrives with a second EHR instance, a risk-based contract introduces another payer file, a vendor relationship brings in laboratory or pharmacy feeds. Their combined effect is a set of systems describing the same patients and members differently. … Signs your organization needs better clinical and claims data integration
How to choose the right risk adjustment vendor
Executive Summary Choosing a risk adjustment vendor should never be reduced to coding function alone. The right platform should improve documentation quality, integrate into clinical and operational workflows, provide transparent analytics, support prospective and retrospective programs, and maintain audit readiness. Organizations should prioritize configurable technology, explainable AI, strong governance, measurable outcomes, and an implementation approach … How to choose the right risk adjustment vendor
Responsible AI in healthcare analytics: The MedInsight approach
Key Highlights Introduction› Analysis in the AI era› Principles of AI adoption at MedInsight› Conclusion› Download the white paper Introduction The recent explosion of artificial intelligence (AI) capability and deployment at scale has dramatically altered conversations and expectations for technology solutions. Healthcare and healthcare analytics are no exceptions to this. AI as a technological innovation … Responsible AI in healthcare analytics: The MedInsight approach
Heart failure admissions: Cost implications of potentially avoidable inpatient care
Key Highlights Background› Methodology› Analysis› Conclusion› Download the article Heart failure (HF) represents one of the most pressing cardiovascular health challenges facing the United States (US). According to the CDC, heart failure occurs when the heart cannot pump enough blood and oxygen to meet the body’s needs. Although it is a serious condition, it does … Heart failure admissions: Cost implications of potentially avoidable inpatient care
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Under CJR-X, the focus is on both quality and 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, the focus is on both quality and cost: Two former CMS officials on what the earlier bundles reveal
THMA Fall 2026 Value-Based Strategy Collaborative
Milliman MedInsight is headed to Washington, D.C. for the The Health Management Academy’s Fall 2026 Value-Based Strategy Collaborative, an invitation-only gathering of senior health system and industry executives focused on advancing value-based care strategy through peer discussion, shared strategy, and practical insight. At this year’s collaborative, we look forward to connecting with leaders across managed … THMA Fall 2026 Value-Based Strategy Collaborative
Healthcare Analytics: 2026 in Review and What’s Ahead for 2027
As 2026 comes to a close, healthcare organizations are navigating a rapidly evolving analytics landscape marked by both significant opportunities and complex challenges. The accelerated experimentation and adoption of AI-driven technologies is transforming how healthcare organizations approach strategy and decision-making, underscoring the critical importance of investing not only in AI capabilities, but also in the trusted, high-quality data … Healthcare Analytics: 2026 in Review and What’s Ahead for 2027
NAACOS Fall 2026
Advancing accountable care at NAACOS Fall 2026 MedInsight will be in Washington, D.C., October 14–16 for the NAACOS Fall 2026 conference, where leaders across accountable care will gather to examine policy updates, emerging models, and real-world strategies for navigating value-based care. ACOs are facing a pivotal moment as payment models evolve, financial risk increases, and … NAACOS Fall 2026
Value-based care for payers: Turning analytics into performance
Value-based contracts are widespread across the payer industry—but results remain uneven. Many health plans have changed how providers are paid without fully transforming how care is managed, how teams collaborate, or how performance is measured. The result? Promising VBC strategies that stall before delivering meaningful ROI. Join Milliman MedInsight for a discussion exploring why incentives … Value-based care for payers: Turning analytics into performance
Milliman HealthVision360 2026
Navigating Healthcare Complexity and Creating Solutions Together Healthcare leaders are facing unprecedented pressure to improve outcomes, control costs, adapt to changing regulations, and make critical decisions with confidence. At Milliman HealthVision360, you’ll gain practical strategies, industry insights, and peer connections designed to help your organization move from complexity to clarity. Join health plan, provider, and … Milliman HealthVision360 2026
