See where every value-based contract stands, months before settlement

Forecast settlements, model contract scenarios, and monitor performance at the provider level, powered by Milliman’s actuarial methodology, all year long.

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Value-based care (VBC) contract management is the practice of tracking and managing how a fee-for-service or risk-based arrangement is performing throughout the year, rather than learning the result only when the final settlement arrives. Payers, ACOs, health systems, and independent physician associations all carry a growing share of their revenue in these arrangements. Payers administering many provider agreements and providers receiving data from many payers face the same difficulty: each contract arrives with its own terms, reporting format, and timeline, which leaves little room to act before settlement.


Year-end settlement vs. year-round contract visibility

Most organizations learn how a value-based contract performed only after the performance year closes. By then, there is no time left to influence the outcome.

Year-end settlement reporting

  • Performance is confirmed only after the year closes
  • Each payer relationship arrives in its own reporting format
  • Results are visible at the ACO or portfolio level
  • Discrepancies with a payer’s figures are difficult to substantiate

Year-round visibility with MedInsight

  • Settlement forecasts update throughout the performance year
  • One standardized report format applies across every agreement
  • Results are visible down to the NPI, TIN, or clinic level
  • Settlement calculations are documented against actual contract terms

Why value-based care contract management matters

Value-based agreements represent a growing share of revenue for providers, and a growing share of administrative complexity for payers. A single organization might be managing MSSP and LEAD agreements alongside custom payer-provider contracts, spanning commercial, Medicare Advantage, Medicare fee-for-service, and Medicaid populations at the same time.

What each level of detail reveals

An ACO-level report can confirm whether an arrangement met its overall target, but it cannot show which providers, practices, or clinics actually drove that result. Provider-level detail turns a single portfolio number into a set of decisions: where to intervene, which relationships are performing, and how to allocate the outcome equitably among participants.

Benefits with MedInsight

1

Forecast settlement performance before year-end

Calculate and compare settlement performance across past, present, and future years, spanning fee-for-service and risk arrangements including MSSP, LEAD, and custom contracts.

2

Model contract scenarios with confidence

Use Contract Builder to configure a proposed contract’s terms and project performance for the coming year, without actuarial consulting support required for every scenario.

3

See performance at the provider level

Monitor performance at the NPI, TIN, or clinic level, and distribute savings and losses among participating providers on an equitable, documented basis.

4

Standardize reporting and audit every settlement

Process each arrangement’s data feed as delivered, then calculate settlements aligned with actual contract terms with documented evidence.

MedInsight’s approach

MedInsight built VBC Contracts on Milliman’s actuarial methodology, applying decades of risk-based contracting experience to a platform purpose-built for payers, providers, and the consultants who support them. Because it runs on the same underlying data as the rest of the MedInsight platform, VBC Contracts stays consistent with an organization’s broader value-based reporting, with one data foundation and no reconciliation gaps between views. The same foundation serves both sides of a value-based agreement: payers can design and administer arrangements across their provider networks, and providers can evaluate proposed terms, monitor performance, and verify settlement across their payer relationships. As a result, payer and provider organizations can negotiate and review their contracts on a clear, documented basis.

For a full walkthrough of how VBC Contracts processes a payer’s data feed and turns it into a settlement forecast, see the VBC Contracts product page.

Who uses VBC Contracts?

If you’re a… You’ll use VBC Contracts to… Side
Payer contracting & VBC program teams Design risk arrangements, model financial implications, and deliver standardized reporting to partners Payer
Provider, ACO & IPA finance teams Forecast year-end settlement, compare performance across contracts, plan cash flow Provider
Consultants Build and share settlement and risk scenarios; help design new arrangements Both
Executive & finance leadership Track financial obligations across the full VBC portfolio, tied to reported financials Both

Use cases across the performance year

VBC Contracts is used differently at different points in a contract’s life.

Before the year begins

Contract modeling & design

Configure a proposed contract’s terms and project its performance before signing, with Contract Builder.

Payer
Provider
Consultant

During the performance year

Financial performance & settlement forecasting

Get a big-picture view of current-year projections across every agreement, compared against prior years.

Payer
Provider

Advanced contract management

Evaluate performance across alternative payment models by comparing payments to actual costs.

Payer
Provider

Scenario development & analysis

Build and share detailed what-if scenarios in the application, or export to Excel for further modeling.

Payer
Provider
Consultant

Standardized reporting & transparency

Deliver consistent, high-quality reporting to provider partners without building it in-house.

Payer
Consultant

Unified performance monitoring

Access comprehensive performance data for multiple contract types and providers in a single platform.

Provider

At year-end

Year-end financial reconciliation

Determine settlement values accurately and reduce reconciliation errors.

Payer
Provider
Consultant

Ready to see what’s possible with year-round visibility into your value-based contracts?

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