Using Comprehensive Analytics to Get Past the Current Health Plan Challenges

Milliman MedInsight®, a leading healthcare analytics and solutions provider, has officially announced an expansion of its Payer Platform. According to certain reports, the stated expansion will harness Milliman’s renowned models, methodologies, and data interoperability to introduce widened analytics capabilities, all for meeting the unique needs of our payer/health insurance market. More on the same would reveal how the company’s Data Confidence Model, an innovative and structured process that ensures the accuracy, reliability, and comprehension of healthcare data collected for customers, will particularly help the renewed payer solution to access unparalleled flexibility and interoperability. This, in turn, will make it possible for health plan stakeholders and users to accelerate their own digital transformation efforts and seamlessly engage with a unified platform and solution across the enterprise. But what does that mean on a more practical note? Well, already known for enabling health plans to monitor cost and utilization trends, gain a deep understanding of member populations, target high-risk individuals, and optimize network performance with greater confidence, the given payer platform can now offer you comprehensive employer group insights. These insights, once analyzed, bear the potential to bolster revenue growth and customer retention, something it will achieve through flexible and self-guided group reporting capabilities.

Next up, we must dig into how the platform can conceive, moving forward, Value Base Care (VBC) Support for Payers. To get there, the solution will offer specific components, such as VBC Contracts that can optimize provider networks, performance tracking, and transparency by providing a comprehensive view of financial performance across contracts. Another component the stated promise will likely involve is a dedicated Provider Portal, which alongside new data streaming technologies, can also offer relevant information at your partners portals for key insights. Joining VBC contracts and the Provider Portal is a set of Provider Profiling capabilities. These capabilities essentially combine reference data and Milliman MedInsight analytics to create the latest framework in provider profiling.

“We are fully committed to driving digital transformation, enabling both ourselves and our customers to achieve true economies of scale at the enterprise level,” said Marcos Dachary, Chief Market Strategist of Milliman MedInsight Payer Solutions. “Health plans’ business questions continue to grow, and now we have the capability to provide them with a wealth of referential data and benchmarks, seamlessly integrated into their user workflow tools. Whether it’s the care teams, support teams, or operational staff, we ensure that data is distributed to where the end users are.”

Moving on, the new and expanded payer platform is even poised to provide a cutting-edge Data Science portal where pre-packaged AI/ML models for use cases, such as disease progression modeling, can help scientists make a significant cut back on their preparation time. Hold on, there is more, considering we still haven’t acknowledged the presence of EHR data integration. The stated integration, in essence, banks upon pre-built direct connections to EHR/EMR’s APIs. If not that, it can also use Milliman for national network connectivity. Finally, our last piece of highlight comes from risk coding workflows. This packs together RADV documentation, risk adjustment coordination, and data acquisition with provider and HCC coding audits tied to claims data and financial goals.

“We are excited to launch the next generation of the Milliman MedInsight Payer Platform, which will empower health plans with the insights and tools they need to optimize their operations and improve outcomes,” said Lauren Piacentini, Director of Payer Analytics at Milliman MedInsight. “Our platform leverages actionable insights, deep learning data analysis, and intelligent solutions, and most importantly, trusted data to address the unique challenges faced by health plans.”