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Featured Resources
Becker’s Payer Issues Roundtable Recap: Key insights for health plan leaders
At this year’s Becker’s Payer Issues Roundtable, one message came through consistently: the challenge for payer organizations isn’t new ideas. They need execution that measurably bends trend while keeping decisions defensible in a more scrutinized environment. Across markets, leaders described a world of tighter margins, higher acuity, member disruption, and growing expectations that plans will … Becker’s Payer Issues Roundtable Recap: Key insights for health plan leaders
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
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ATRIO: From insight to impact
ATRIO Health Plans is an organization owned by several providers in and around Salem, Oregon. It has almost 30,000 members, and 90% are Medicare enrollees. The challenge As with every health plan, ATRIO is constantly looking for ways to improve patient care and the bottom line. The approach When ATRIO made the strategic decision to … ATRIO: From insight to impact
What’s new in the MedInsight benchmark portfolio: guiding our client’s challenges in population health, financial analysis, and network management
MedInsight has long been an industry leader in benchmarking capability. In 2020, we have partnered to greater extents than ever before with our clients to leverage our long line of population-based benchmarks, notably the world famous well managed actuarial model and our Guideline Analytics partnership with MCG. Additionally, in 2020 MedInsight greatly expanded its portfolio … What’s new in the MedInsight benchmark portfolio: guiding our client’s challenges in population health, financial analysis, and network management
Top 5 ways to leverage Milliman data assets for strategic healthcare market analysis
What are the critical considerations and data challenges related to understanding your local healthcare markets? Join us for a conversation with healthcare market analytics and management experts from Milliman to learn more about: Identifying competitive advantages in local markets Evaluating your strategic positioning in the market Conducting effective network evaluation Developing data-driven market expansion strategies … Top 5 ways to leverage Milliman data assets for strategic healthcare market analysis
Telehealth expansion and other creative strategies for caring for patients during COVID-19 – stories from two clients
In this webinar, leaders from Avera Health Plans, Inc., Avera eCare, and the Care Coordination Institute share strategies they have deployed to provide care for patients outside of traditional healthcare settings in response to the COVID-19 pandemic. This includes dramatically expanding telehealth utilization, monitoring chronic conditions through at-home or drive-through strategies, reconfiguring call center functions, … Telehealth expansion and other creative strategies for caring for patients during COVID-19 – stories from two clients
Pandemic induced medical loss ratio opportunities
Medical expenditures in the US were down steeply in 2020 due to deferred and forgone care associated with the COVID-19 pandemic, leading to historically low medical loss ratios (MLR) for insurers. For insurers, who must comply with state and federal minimum MLR regulations or pay costly rebates and remittances, this state of affairs brings with … Pandemic induced medical loss ratio opportunities
Medical action planning at Ochsner Health Network
Join us to learn how Ochsner Health uses Cost and Utilization analysis to measure performance and identify opportunities to lower the cost of care. Ochsner will share how they have leveraged MedInsight to understand cost drivers and engage their providers and healthcare systems in actionable ways, by bringing together all payer data to standardize reporting … Medical action planning at Ochsner Health Network
