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Harnessing analytics and AI: A modern guide to risk adjustment
Value-based care (VBC) models are reshaping the delivery, measurement, and funding of healthcare at an accelerated pace, making precise risk-adjustment processes essential for ensuring that reimbursements and premiums accurately reflect actual care costs. Accurate risk adjustment creates a fair and sustainable link between healthcare costs and provider compensation in risk-sharing arrangements. To succeed requires careful … Harnessing analytics and AI: A modern guide to risk adjustment
Top 3 takeaways from NAACOS Spring 2025 Conference
The NAACOS Spring Conference 2025, held April 22-24 in Baltimore, brought together a dynamic mix of healthcare professionals, policymakers, and innovators, dedicated to shaping the future of Accountable Care Organizations (ACOs). This year’s event underscored the need for health systems to address evolving challenges and advance value-based care (VBC) to enhance care quality, improve patient … Top 3 takeaways from NAACOS Spring 2025 Conference
Becker’s Payer Issues Roundtable 2025: Charting Medicare Advantage growth
In April, the Becker’s Payer Issues Roundtable 2025 gathered industry leaders to examine the key challenges facing payers, including the impact of changing regulations and the future of Medicare Advantage (MA). Marcos Dachary, Principal and Chief Market Strategist and General Manager of Payer Solutions at Milliman MedInsight, participated in a panel discussion to explore topics … Becker’s Payer Issues Roundtable 2025: Charting Medicare Advantage growth
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Supercharging healthcare analysis with robust provider data
Organizations in and around the healthcare industry are clamoring for more data and more data-driven insights to guide their decisions. At their core, many of these decisions rely on an understanding of the overall healthcare system. Understanding the healthcare system in turn requires an understanding of healthcare providers working in the system, as well as … Supercharging healthcare analysis with robust provider data
Advancing patient care through data integration
In this video, Southeastern Health Partners CEO, Keith Newnam, and IT Consultant, Dino Capone, discuss the benefits of their collaboration with Milliman MedInsight. They explain how the partnership addresses data challenges and enhances patient care by integrating innovative data strategies. For more information, read our case study here.
Navigating risk and revenue growth: A CFO’s guide to value-based contracts
As healthcare reimbursement models shift towards value-based care (VBC), chief financial officers (CFOs) are increasingly at the forefront of managing the financial implications of these changes. Not only are CFOs instrumental in assessing and mitigating the risks associated with new contracting models, but they are also responsible for ensuring that their organizations can thrive in … Navigating risk and revenue growth: A CFO’s guide to value-based contracts
Exploring the provider landscape in Sickle Cell Disease through a gene therapy lens
Sickle Cell Disease (SCD) is one of the most common genetic disorders in the world. The disease has significant impacts on quality of life and life expectancy for racial and ethnic minorities in the United States. Breakthrough, potentially curative gene therapy treatments have recently been developed and approved but remain costly and difficult to provide … Exploring the provider landscape in Sickle Cell Disease through a gene therapy lens
Increased spending on low-value care during the COVID-19 pandemic in Virginia
The U.S. spends more money on healthcare than other countries without commensurate improvement in health outcomes. Part of this wasteful spending is attributed to low-value care, services for clinical scenarios that lack evidence and therefore do not benefit health, raise costs, and sometimes cause patient harm. Examples are cardiovascular screening tests for asymptomatic low-risk patients … Increased spending on low-value care during the COVID-19 pandemic in Virginia
The power of insight: Enhancing VBC contract management and outcomes with analytics
The transition towards value-based care (VBC) is rapidly reshaping the healthcare landscape. While this shift holds immense promise for improving patient outcomes and reducing costs, it also presents a unique set of challenges that demand careful consideration for successful contract negotiations and management. In this blog post Milliman MedInsight product manager, Umang Gupta, explains the … The power of insight: Enhancing VBC contract management and outcomes with analytics
