At Milliman MedInsight®, we understand that Accountable Care Organizations (ACOs) are revolutionizing healthcare by shifting the payment process from quantity-based services to quality-based care outcomes. To achieve value-based care goals, ACOs require a scalable analytics approach to identify opportunities for improving care quality, controlling costs, and minimizing financial risk.
With VBC Insights, included in MedInsight’s Value-Based Care Platform, users can effortlessly track utilization trends over time and dive into individual patient cohorts to uncover cost-saving opportunities. Powered by the expertise of Milliman, these customizable, prescriptive, and comprehensive reports are designed to support executive-level reporting and teams of all analytic ability levels. The advantages of using VBC Insights include:
Single source of truth
Deliver reliable data and insights to clinical and operational stakeholders to support informed decision-making.
High-quality data & benchmarks
Compare performance confidently to tailored benchmarks that account for risk and demographic factors at the service category level.
Optimized performance
Extend your data analytics capability with a dynamic interface that pinpoints opportunities to close care gaps and minimize waste.
Speed to insight
Monitor cost drivers, quality of care, and utilization and cost trends over time with intuitive dashboards and reporting views.
Integrated population views
Define and stratify patient populations that could benefit from additional support and outreach by care coordinators.
Increased transparency & trust
Leverage transparent criteria for cost and patient care performance to build provider trust and impact behaviors.
VBC Insights in action
Insights dashboard
Identify and prioritize cost savings and quality improvement opportunities
Deliver high-quality, cost-effective care by gaining a deeper understanding of how to reduce unneeded emergency department (ED) visits, hospital admissions, readmissions, post-discharge care, medication use, and out-of-network utilization.
Optimize efficiencies and outcomes
Free up valuable resources and identify opportunities more efficiently and in less time with contextualized reports that can easily be filtered (e.g., time periods, demographic characteristics, provider groups or regions, or other criteria) and plug into existing workflows.
Increase performance, satisfaction, and profitability
Increase alignment and the likelihood of value-based care success by providing stakeholders with meaningful insights needed for prioritizing strategic initiatives and achieving shared goals.
Use cases: How VBC Insights can help
Chronic condition management
Gain holistic views of patients’ health to proactively identify and stratify those who are at risk and those who are most likely to benefit from care management.
Network leakage analysis
Encourage in-network referrals and care by understanding patient preferences, provider referral patterns, and cost and utilization of specific services.
Pharmacy trends
Track utilization, adherence and cost of prescriptions used to treat acute/chronic conditions and gain visibility into high/low utilizers and medication adherence.
Post-acute (PAC) savings opportunities
Drill into PAC episodes by diagnosis-related group (DRG) and by facility (e.g., skilled nursing facility, home health). Leverage Milliman-developed benchmarks to understand cost drivers and potential savings.
Provider profiling
Optimize care and outcomes by assessing provider performance, identifying variations in care delivery, and uncovering opportunities for quality improvement and cost reduction.
Avoidable ED utilization
Monitor overall ED visits, including preventable and non-preventable ED utilization within value-based reimbursement programs.
Relevant resources
How digital transformation drives value-based care
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2024 Outlook: Five key analytic capabilities shaping VBC
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Leading the way in value-based care: Best practices for mitigating risk
The healthcare landscape is rapidly evolving to one in which value and accountable care are the predominant measures for delivering high-quality, affordable care. It is an evolution that has been underway for more than a decade, but recent years – and the demands of an aging population – have brought transformation at a rapidly growing … Leading the way in value-based care: Best practices for mitigating risk
The right data for every model of value-based care contracting
How MedInsight Supports Organizations on the Glide Path to Risk For healthcare provider organizations navigating the array of alternative payment models in use across all phases of value-based care contracting, the complexity can be daunting. From small physician groups operating on a largely fee-for-service basis to health plans managing the claims of tens of thousands … The right data for every model of value-based care contracting
Reducing risk to drive VBC success for ACOs
As value-base care (VBC) progresses, accountable care organizations (ACOs) face a significant challenge in balancing the quality of care and financial outcomes while taking on increasing financial risk. This task becomes even more difficult without a comprehensive understanding of patient populations and overall performance, making it challenging to sustain value-based care effectively. ACOs typically have … Reducing risk to drive VBC success for ACOs
Reporting Framework for Value Based Care
As the cost of healthcare continues to rise, both payers and providers continue the “triple aim” of delivering effective quality care while managing their costs. Value based care (VBC), or value based reimbursements, has emerged as an effective mechanism for achieving this goal. In fact, based on estimates developed by National Business Group on Health, … Reporting Framework for Value Based Care