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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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Practice patterns of antibiotics prescriptions for URI
Antibiotics are prescribed at more than 100 million adult ambulatory care visits annually, and 41% of these prescriptions are for respiratory conditions. In the United States, at least 2 million antibiotic-resistant illnesses and 23,000 deaths occur each year, at a cost to the U.S. economy of at least $30 billion.1 The most common reason for … Practice patterns of antibiotics prescriptions for URI
Nonprofit health system: Improve patient outcomes by “looking outside the silo”
When one of the South’s largest not-for-profit healthcare systems recently searched for a new healthcare data analytics solution, a key goal was establishing a consistent methodology for identifying and solving problem areas. A previous attempt with another data aggregator and vendor had stalled: a messy implementation process had dragged on for years, and even worse, … Nonprofit health system: Improve patient outcomes by “looking outside the silo”
How to ensure effective & agile healthcare decision-making
Between what’s publicly available and what your organization has captured, there’s no shortage of healthcare data – but is it current? Can you trust it? Can you identify conclusions and trends within it? Most importantly, can you make meaningful decisions and take impactful actions with confidence based on your healthcare data? Making more timely, well-informed … How to ensure effective & agile healthcare decision-making
Step up your data-driven healthcare capabilities with the MedInsight Strategic Alliance Program
Improving the quality of patient care, after all, is the end game of everything we do at Milliman MedInsight. And while we bring decades of insight and experience to the effort, revolutionizing the future of healthcare is bigger than any single enterprise. It will require an ecosystem of strategic and technology alliances. That is a … Step up your data-driven healthcare capabilities with the MedInsight Strategic Alliance Program
