About

Milliman MedInsight® is one of the healthcare industry’s most highly regarded platforms for data warehousing and healthcare analytics, and has been adopted by payers, purchasers, providers and other healthcare clients. Additional MedInsight products include solutions that provide preconfigured or custom reporting and data configurations, as well as individual tools that can address specific business needs.

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MedInsight’s analytics are used by many types of healthcare organizations, including health plans, at-risk providers/ACOs, employers, third-party administrators, state Medicaid agencies, and multi-payer coalitions. Common use cases for which MedInsight is used include cost and utilization analysis, employer group reporting, population health management, care management, quality and efficiency measurement, and avoidable events and services.

California MedInsight study

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Covered California: Leveraging Telemedicine for Network and Quality Management

Healthcare purchasers, including state-based marketplaces, are making a push to move healthcare payments from volume to value and to transform the delivery system to promote quality of care. Covered California is seeking to do this through its contracting health plans and the qualified health plan (QHP) solicitation process. The most recent solicitation lays out key milestones for the 2017 to 2019 plan years. Beginning in 2017, during the annual QHP certification, a contracting plan will be required to "report on its strategies to ensure that contracting Providers are not charging unduly high prices and for what portion of its entire enrolled population it applies each strategy." Strategies may include various tactics to move toward value-based payments, drive enrollees to high-value providers, and engage enrollees in decision-making and their own health management.

Milliman MedInsight® can assist health plans and providers with developing appropriate strategies, identifying analytic requirements, and conducting analysis to support them in their network management, quality management, and transformation efforts. We will be releasing a series of articles on these related topics. To request the first of the series, please fill out the form to the right.

This first article is "Leveraging Telemedicine and Digital Health Tools as a Strategy for Network and Quality Management.”

Request the brief