Healthcare Data Analytics & Value-Based Care Resources | MedInsight

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TCOC case study

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

Patient consultation

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

Woman with laptop

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 case study

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

SEHP Case Study

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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