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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
AI in healthcare analytics: Milliman MedInsight’s approach to delivering trusted answers at speed and scale
Organizations are under growing pressure to make faster, more confident decisions in an increasingly complex healthcare environment. As healthcare continues shifting to value-based care, administrative tasks and data volumes are both growing. Although many leaders see artificial intelligence (AI) as a possible solution, it also brings new challenges. Without access to accurate data, a strong … AI in healthcare analytics: Milliman MedInsight’s approach to delivering trusted answers at speed and scale
Value-based care requires value-based operations: A framework for operational alignment
In healthcare, value-based care (VBC) is more than a familiar phrase. It represents a commitment to better patient outcomes and more thoughtful use of resources. Yet as the industry shifts from fee-for-service (FFS) reimbursement to value-based contracts, a significant gap persists. We often focus on contract design, aligned incentives, shared savings, and risk-bearing arrangements. But … Value-based care requires value-based operations: A framework for operational alignment
Beyond the diagnosis: The financial toll of cancer amid chronic conditions
Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths. In the United States, the percentage of adults who have ever been diagnosed with cancer is 10.3% in 2024 and cancer is the number two cause of death across all chronic conditions. Cancer … Beyond the diagnosis: The financial toll of cancer amid chronic conditions
Optimizing the Total Cost of Care with payer analytics
Health plans now operate in a far more complex environment than in past years. With economic uncertainty, shifting market forces, and regulatory changes, there is increasing pressure for health plans to do more than just maintain performance; they must deliver real, measurable value. To succeed in managing the Total Cost of Care (TCOC), health plans … Optimizing the Total Cost of Care with payer analytics
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Reducing Healthcare Waste: A Three Pronged Approach
Practical Analytic Approaches to Healthcare Challenges Experts and stakeholders across the industry agree that there is an immediate need to reduce wasteful healthcare spending in the US. A 2012 Institute of Medicine report estimated that one third of US healthcare spending, or $750 billion is wasted annually (Washington Post, September 2012). Of that amount, $210 … Reducing Healthcare Waste: A Three Pronged Approach
Wasteful Pre-Operative Cardiac Testing Prior to Low-Risk Surgery
Practical Analytic Approaches to Healthcare Challenges Anesthesiologists perform pre-operative assessment on all patients undergoing surgery in order to identify any disease or risks to the surgery and to plan perioperative anesthetic care to mitigate surgical risk. In patients with known cardiac disease, diagnostic cardiac tests such as stress tests and echocardiograms are sometimes recommended as … Wasteful Pre-Operative Cardiac Testing Prior to Low-Risk Surgery
Pre-operative Laboratory Testing for Low Risk Surgeries
Practical Analytic Approaches to Healthcare Challenges Routinely performing pre-operative testing is a common practice prior to surgery. The American Society of Anesthesiologists (ASA) Task Force defines routine tests as those done in the absence of any specific clinical indication or purpose (i.e. tests intended to discover a disease or disorder in an asymptomatic patient).1 Routine … Pre-operative Laboratory Testing for Low Risk Surgeries
Is Risk Adjustment Enough in Population Analytics?
Practical Analytic Approaches to Healthcare Challenges Most analysts conducting population health data analysis understand that no two populations are completely the same. Even within a population with similar attributes – people with congestive heart failure, for example – there will be variances in the population subgroups. Many factors contribute to these variances, including age and … Is Risk Adjustment Enough in Population Analytics?
Task Force on Low Value Care: Fall Convening
Practical Analytic Approaches to Healthcare Challenges The excitement in the room was palpable as 28 attendees descended on the Westin’s Earhart Room in Detroit, Michigan. Stakeholders from across the nation gathered on September 13 with a common goal—to reduce wasteful healthcare services in the United States. Our charge for the day was to prioritize 29 … Task Force on Low Value Care: Fall Convening
What a Pain: Wasteful Low Back Pain Treatments Are Identified
Practical Analytic Approaches to Healthcare Challenges Low back pain is a common problem: more than one in four adults surveyed report having had low back pain during the past three months. Though most low back pain resolves on its own, without medical intervention, it remains one of the most common reasons for physician visits. Imaging … What a Pain: Wasteful Low Back Pain Treatments Are Identified
