Learn more about MedInsight in our latest resources
Featured Resources
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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Build the right data stack: How to integrate clinical and claims data for actionable intelligence
Best practices for processing clinical and claims data to support modern analytical and reporting needs Healthcare organizations are increasingly challenged to extract value from vast and varied data sources, especially as clinical and claims data become central to decision-making, regulatory compliance, and value-based care initiatives. Yet, the complexities of processing, integrating, and standardizing these data … Build the right data stack: How to integrate clinical and claims data for actionable intelligence
NAHDO Virtual Conference Fall 2025
Milliman MedInsight at the National Association of Health Data Organizations (NAHDO) Virtual Conference Milliman MedInsight will attend the National Association of Health Data Organizations (NAHDO) Virtual Conference as we support their nationwide effort to improve the collection, analysis, and use of healthcare data for market analysis, policy development, and research. As a long-standing advocate for … NAHDO Virtual Conference Fall 2025
Measuring the unseen: Differentiation in health system services
Some health systems offer comprehensive services, while others are narrower in scope. Understanding service differentiation gives organizations important strategic insight. In this whitepaper, our goal is to illustrate one approach organizations may leverage in thinking about and quantifying a health system’s differentiation in its various markets.
THMA Fall 2025 Value-Based Strategy Collaborative
Milliman MedInsight is excited to take part in The Health Management Academy’s Fall Value-Based Strategy Collaborative—an exclusive forum for senior health system executives driving the next wave of value-based care (VBC), population health, and payer-provider innovation. We’ll be engaging with leaders such as Chief Population Health Officers, SVPs of Value-Based Care Strategy, Chief Managed Care … THMA Fall 2025 Value-Based Strategy Collaborative
HLTH 2025
Empowering Healthcare Heroes: Accelerate Innovation and Impact with Milliman MedInsight Every legend begins with a bold vision—and at HLTH 2025 in Las Vegas, you’re invited to become part of healthcare’s next heroic chapter. This year’s HLTH theme, “Heroes and Legends,” celebrates those who are pioneering change and shaping the future of healthcare. Join Milliman MedInsight … HLTH 2025
Introducing our new eBook: The intersection of clinical data integration and value-based care: Strategies for success
As healthcare pivots towards value-based care (VBC), providers face intricate challenges centered on enhancing patient outcomes while managing costs effectively. This shift demands not only a change in approach but also a sophisticated integration of healthcare data to drive meaningful improvements. At the heart of VBC lies the seamless integration of Electronic Health Record (EHR) … Introducing our new eBook: <em>The intersection of clinical data integration and value-based care: Strategies for success</em>
