Learn more about MedInsight in our latest resources
Featured Resources
Under CJR-X, quality decides more than cost: Two former CMS officials on what the earlier bundles reveal
Key Highlights Introduction › Interview › What this means for your hospital › With the CJR-X final rule now released in July 2026, the first mandatory, nationwide episode-based payment model for lower extremity joint replacement is set to begin on January 1, 2028. For most acute care hospitals, participation is now settled and required, and … Under CJR-X, quality decides more than cost: Two former CMS officials on what the earlier bundles reveal
Mitigating the impact of high-cost claimants: A payer analytics approach to total cost of care
It has long been understood that a relatively small portion of any covered population accounts for a disproportionately large share of healthcare spending. A 2025 study by the Employee Benefit Research Institute (EBRI), which examined 13.1 million individuals with employer-sponsored health coverage in 2022, found that the highest-cost 20% of members were responsible for 84% … Mitigating the impact of high-cost claimants: A payer analytics approach to total cost of care
Why VBC still fails for mature organizations: What actually separates high performers
Value-based care (VBC) has moved well beyond experimentation. For many healthcare organizations, value-based contracts now represent a significant share of revenue, risk exposure, and strategic focus. The industry has largely resolved the question of whether to participate in these models. What remains unresolved is how to manage them most effectively. Increasingly, a common source of … Why VBC still fails for mature organizations: What actually separates high performers
CJR-X starts January 2028. The hospitals that win are starting now
CMS has finalized the first nationwide expansion of an episode-based payment model, and by its own account the largest such model in Medicare’s history: a mandatory program covering lower extremity joint replacements (LEJR). It is called CJR-X, short for Comprehensive Care for Joint Replacement Expanded, and it begins January 1, 2028, as an ongoing program … CJR-X starts January 2028. The hospitals that win are starting now
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
Browse our full library of resources
All resources
Milliman acquires Torch Insight, expanding industry’s leading portfolio of SAAS health market intelligence solutions
Seattle, WA —August 18, 2020—Milliman, Inc. today announced the acquisition of Torch Insight® from Leavitt Partners, LLC. This acquisition will combine Torch Insight’s powerful market–centered data and analytics with MedInsight, Milliman’s flagship healthcare analytics ecosystem. Torch Insight brings Milliman decades of healthcare policy expertise and healthcare analytic experience backed by Leavitt Partners – recognized experts … Milliman acquires Torch Insight, expanding industry’s leading portfolio of SAAS health market intelligence solutions
Doing Predictive Analytics with Python: Podcast Series
Practical Analytic Approaches to Healthcare Challenges Python is a very popular coding language for doing predictive modeling and data science. We have been discussing python as part of our ongoing Predictive Analytics podcast series for the Society of Actuaries. Four episodes are available for listening now: Episode 1: This is the first of a few podcasts … Doing Predictive Analytics with Python: Podcast Series
Frameworks and considerations for COVID-19 related analyses
What is the impact of COVID-19 on patterns of healthcare utilization, healthcare costs, and population health? This brief provides an analytic guide to assist healthcare organizations with COVID-19 pandemic analytics.
The increasing relevance of risk scores on MSSP ACOs
Practical Analytic Approaches to Healthcare Challenges Medicare Advantage plans have long recognized the importance of coding to ensure accurate risk scores and clinical documentation. By contrast, Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) often focus less on the implications of risk adjustment or assume they have little ability to affect … The increasing relevance of risk scores on MSSP ACOs
Telehealth Data Analytics: Adoption Trends & Value
Practical Analytic Approaches to Healthcare Challenges Telehealth is the use of electronic information and telecommunication technologies to support remote clinical healthcare, patient and professional health-related education, public health, and health administration. Currently millions of Americans are residing in areas with a shortage of primary healthcare providers and often experience delays to see a provider.[i] Telehealth … Telehealth Data Analytics: Adoption Trends & Value
Milliman MedInsight ranked best in KLAS for payer quality analytics for second year in a row
Seattle – January 31, 2020 – MedInsight, Milliman, Inc.’s highly regarded platform for data warehousing and healthcare analytics, ranked number one in the 2020 Best in KLAS: Software and Services report for Payer Quality and Risk Analytics. MedInsight receives this honor for the second year in a row. KLAS, a research firm focused on the … Milliman MedInsight ranked best in KLAS for payer quality analytics for second year in a row
