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Turn total cost of care strategy into measurable action
Healthcare payers are under growing pressure to reduce costs while managing rising utilization, unit cost, pharmacy spend, and medical expense trends. But analytics alone are not enough. To create measurable impact, health plans need trusted data, actuarial alignment, enterprise governance, and a repeatable process for turning insights into action. In this case study, see how … Turn total cost of care strategy into measurable action
The decade of full risk starts now: Four workflows separate ACOs ready for it
The conditions for value-based care (VBC) have just shifted, as stronger financial results, improved data usability, and new long-term CMS incentives reshape what it takes for Accountable Care Organizations (ACOs) to compete and succeed. ACOs have had access to Centers for Medicare & Medicaid Services (CMS) claims data for years. What has made the difference … The decade of full risk starts now: Four workflows separate ACOs ready for it
Healthcare payer analytics: Challenges, findings, and next steps
Health plans are investing heavily in analytics and artificial intelligence (AI) but are they getting the results they need? That was the central question at Milliman MedInsight’s June 18th webinar: Data-Driven Payer Strategies: Survey Insights and Solutions. Presenters Marcos Dachary (Milliman MedInsight Principal, Chief Market Strategist and General Manager of Payer Solutions), Lauren Piacentini (Milliman … Healthcare payer analytics: Challenges, findings, and next steps
MA Plan identifies hidden cost drivers and recovers millions through deeper inpatient cost transparency
When a Midwest provider of MA plans was facing mounting costs that its legacy analytics capabilities could not explain, the organization sought help with analyzing utilization costs by facility, market and product, and surfacing trends and insights that could identify cost-saving opportunities. Without the ability to drill down into cost drivers, the unjustifiably high acuity … MA Plan identifies hidden cost drivers and recovers millions through deeper inpatient cost transparency
Research hospital executes a challenging shift to more cost-effective clinical care
When one of the country’s flagship research hospitals sought to shift from high-cost academic work to more cost-effective and sustainable clinical care, the organization began a restructuring designed to improve clinical and financial outcomes in its population of approximately 645,000 at-risk patients, with a focus on the Medicare Shared Savings Program (MSSP) and Medicaid. To … Research hospital executes a challenging shift to more cost-effective clinical care
New report shows how healthcare payers are using analytics and AI to drive impact
Healthcare payers are making big investments in analytics, AI, and digital transformation with the goal of translating data into bottom line efficiencies and improved member experiences. For many payers, however, system integration, staffing, and improved data quality are needed to fully translate analytics investments into the operational gains they are seeking. Those are among the … New report shows how healthcare payers are using analytics and AI to drive impact
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Assessing the impact of COVID-19 on risk contracts
During this time of national uncertainty, health care providers are fully engrossed in maintaining daily operations and ensuring continuity of care for their patients amid the COVID-19 crisis. COVID-19 creates a myriad of uncertainties for Accountable Care Organizations (ACOs), which can seem overwhelming. Understanding the economic and clinical impact of COVID-19 requires innovative and flexible … Assessing the impact of COVID-19 on risk contracts
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
Advancements in quantifying low-value care opportunity: Reducing harmful cascades of care
Cascades of care refer to a succession of medical services that are often fueled by the desire to avoid even the smallest risk of a serious condition. They can follow from incidental or marginal findings on screening and diagnostic tests, some of which are themselves of low-value. Cascades of care are common and can be … Advancements in quantifying low-value care opportunity: Reducing harmful cascades of care
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
THMA Fall 2025 CFO Forum
Milliman MedInsight to join The Health Management Academy Fall 2025 CFO Forum Milliman MedInsight is excited to join The Health Management Academy Fall CFO Forum—an exclusive convening of Chief Financial Officers from the nation’s top health systems and pioneering healthcare organizations. This premier event provides a unique platform for meaningful connections and open dialogue on … THMA Fall 2025 CFO Forum
Medicaid Innovations Forum
Join us at the Medicaid Innovations Forum! We’re excited to participate in this forward-thinking conference, where leaders from Medicaid health plans, state agencies, and industry organizations come together to share practical insights and real world strategies. Designed to help stakeholders navigate today’s evolving policy landscape, this event features case study presentations, expert panel discussions, and … Medicaid Innovations Forum
