Modernizing healthcare analytics to deliver faster cost and utilization insights

Cambia Health Solutions (Cambia) serves more than 2 million members through its regional health plans and is guided by a mission to make healthcare easier and lives better. To support that mission, the organization set out to strengthen its analytics foundation with a more scalable, reliable approach to delivering timely, trusted insights for actuarial and healthcare informatics teams.

The challenge: Working with fragmented data

Before Milliman MedInsight (MedInsight), Cambia’s analytics environment relied on dozens of separate data sources, legacy tools, and internally maintained processes. Teams often had to pull together information from many different systems, each with different structures, update cycles, and levels of reliability. This fragmented environment made it difficult to move quickly from data gathering to insight generation.

The impact on analysts was significant. In many cases, teams were spending the vast majority of their time assembling and reconciling data instead of analyzing it. This slowed decision-making, limited the organization’s ability to identify cost and quality opportunities, and created friction for teams trying to support business priorities. According to Shelley Webb, Cambia’s actuarial director, “Before MedInsight, too much of the process was spent reconciling fragmented data, which limited our ability to generate timely insights and act on opportunities.”

A phased analytics implementation that balanced speed and enterprise strategy

Cambia’s path to implementation required cross-functional alignment, a strong business case, and close collaboration among analytics, technology, and executive stakeholders. The organization identified the opportunity in 2023, worked through a formal evaluation and funding process, and ultimately received approval to move forward in 2025.

To balance near-term business needs with long-term data strategy, Cambia and its internal technology partners aligned on an interim approach. This allowed actuarial and healthcare informatics teams to begin using MedInsight while the broader enterprise data environment continued to evolve. That phased strategy helped Cambia accelerate value while maintaining alignment with enterprise governance goals.

From data aggregation to faster cost and care insights

With MedInsight in place, Cambia gained a more connected and efficient analytics experience. Teams that previously had to work across dozens of sources could now access a more integrated view of data in one place. This made it much easier to explore trends, drill into variation, and test hypotheses quickly.

One early area of value was in identifying cost variation across procedures and care settings. With faster access to integrated analytics, Cambia could move beyond broad observations and uncover more specific drivers of variation. The organization was also able to connect episode and classification views more effectively, supporting deeper analysis of cost differences across providers and treatment settings.

For example, Cambia was able to connect previously disparate data systems and examine specific clinical use cases, such as multiple myeloma (a complex condition that can lead to different responses by treatments). By bringing together integrated claims and analytic views, teams could look more closely at variation in treatment patterns, site of care, and the cost implications of different approaches. Benchmarking helped Cambia quickly identify a consistent pattern of higher inpatient surgery rates across its Medicare Advantage populations, regardless of state. That level of detail helped Cambia move from broad trend analysis to more targeted questions about where opportunities for improvement and cost-effectiveness might exist. Cambia expected MedInsight to help uncover $5 million to $10 million in annual incremental savings, but the results came faster and larger than anticipated. Just six months into the year, the organization had already identified 2 to 3 times that amount in potential program additions and cost-containment adjustments, reflecting not only the power of MedInsight but also Cambia’s ability to pair analytics with the teams responsible for turning insight into action.

Overall, these improvements helped shift effort away from manual data preparation and toward higher-value analysis. Instead of spending most of their time gathering data, analysts could focus more on identifying opportunities, informing negotiations, and supporting strategic decisions with evidence. Webb explained, “By bringing data into one place, MedInsight gave us a more efficient way to explore variation, evaluate opportunities, and support decisions with greater confidence.”

Early Results: Better performance, broader access, and faster answers

Although MedInsight had only been live for a short time, Cambia reported meaningful early benefits, including faster performance, quicker answers to business questions, and the ability to access data in one place. The MedInsight Payer Platform expanded access to analytics by making it easier for less technical users to work directly in browser-based tools, rather than relying only on specialized data skills or custom workflows. At the same time, more advanced users found the platform flexible enough to support deeper analysis that previously required work in backend data marts, helping Cambia serve a wider range of analytic needs in one environment.

As the platform began delivering value, Cambia stakeholders pointed to improvements in both analytic capabilities and the way teams worked with MedInsight:

Just as important, Cambia described the experience as a partnership rather than a standard vendor relationship. The MedInsight team was seen as responsive, collaborative, and willing to work through complex requirements rather than forcing Cambia into a rigid model. That partnership helped build confidence throughout implementation and accelerated adoption among key users across the organization.

Building a future-ready analytics foundation for better care and lower costs

For Cambia, MedInsight represents more than a technology investment. It is a foundational step toward a more agile, scalable analytics environment that can better support cost-effectiveness, care improvement, and business decision-making. By reducing fragmentation and improving access to trusted insights, Cambia is better positioned to turn data into action across its organization in support of its mission.