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AI in healthcare analytics: Milliman MedInsight’s approach to delivering trusted answers at speed and scale
Organizations are under growing pressure to make faster, more confident decisions in an increasingly complex healthcare environment. As healthcare continues shifting to value-based care, administrative tasks and data volumes are both growing. Although many leaders see artificial intelligence (AI) as a possible solution, it also brings new challenges. Without access to accurate data, a strong … AI in healthcare analytics: Milliman MedInsight’s approach to delivering trusted answers at speed and scale
Value-based care requires value-based operations: A framework for operational alignment
In healthcare, value-based care (VBC) is more than a familiar phrase. It represents a commitment to better patient outcomes and more thoughtful use of resources. Yet as the industry shifts from fee-for-service (FFS) reimbursement to value-based contracts, a significant gap persists. We often focus on contract design, aligned incentives, shared savings, and risk-bearing arrangements. But … Value-based care requires value-based operations: A framework for operational alignment
Beyond the diagnosis: The financial toll of cancer amid chronic conditions
Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths. In the United States, the percentage of adults who have ever been diagnosed with cancer is 10.3% in 2024 and cancer is the number two cause of death across all chronic conditions. Cancer … Beyond the diagnosis: The financial toll of cancer amid chronic conditions
Optimizing the Total Cost of Care with payer analytics
Health plans now operate in a far more complex environment than in past years. With economic uncertainty, shifting market forces, and regulatory changes, there is increasing pressure for health plans to do more than just maintain performance; they must deliver real, measurable value. To succeed in managing the Total Cost of Care (TCOC), health plans … Optimizing the Total Cost of Care with payer analytics
Bridging the gaps: Ensuring provider network adequacy with the Milliman Network Optimizer
Building a provider network that meets adequacy standards is no small feat for healthcare organizations. As regulatory requirements evolve and patient needs diversify, ensuring beneficiaries have timely access to the right providers becomes increasingly complex. Organizations must navigate a maze of compliance benchmarks, analyze vast and often fragmented data, and address gaps across multiple specialties … Bridging the gaps: Ensuring provider network adequacy with the Milliman Network Optimizer
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Milliman MedInsight launches Network Optimizer to enhance provider management
Seattle, WA – January 29, 2026 – Milliman MedInsight® (MedInsight), a leading healthcare data and analytics software provider and division of Milliman, announced today the introduction of the Milliman Network Optimizer application. Powered by Milliman’s industry expertise and the MedInsight Provider Registry, the Network Optimizer delivers actionable insights beyond traditional adequacy measures. It evaluates provider … Milliman MedInsight launches Network Optimizer to enhance provider management
Provider network optimization – Finding value in the details
Timely access to healthcare services is an important enabler of positive health outcomes. Access to care remains a significant challenge in the United States where, historically, approximately 16% of adults Americans have reported long wait times and difficulty getting appointments for routine care as soon as needed. Demand for healthcare services has grown over the … Provider network optimization – Finding value in the details
Network Optimizer
The Milliman Network Optimizer empowers healthcare organizations and regulators to build and manage high-performing networks with confidence.
Breaking the cycle: Analyzing avoidable ER trips and what can be done about them
This study examines patterns and drivers of Emergency Department utilization in the United States by applying the NYU Emergency Department Algorithm to a large, multi-year claims dataset to identify potentially avoidable visits and populations that could benefit from targeted care management interventions.
RISE National 2026
Join us at RISE National 2026! This premier event brings together more than 1,600 health plan executives, providers, regulators, and industry partners to explore today’s shared challenges and regulatory priorities across Medicare Advantage, Medicaid, risk adjustment, Stars, compliance, member experience, and operations. Visit the Milliman MedInsight booth and discover how you can: Unlock the full … RISE National 2026
Milliman MedInsight powers 2026 value-based care with ONC eCQM certification and next-generation clinical data integration
Seattle, WA — January 20, 2025 — Milliman MedInsight® (MedInsight), a leading healthcare data and analytics division of Milliman, is entering 2026 with accelerating momentum in value-based care. Milliman MedInsight has earned Office of the National Coordinator for Health Information Technology (ONC) certification for electronic Clinical Quality Measures (eCQM) under the Health IT Certification Program. … Milliman MedInsight powers 2026 value-based care with ONC eCQM certification and next-generation clinical data integration
