MedInsight for Health Plans & Payers

Healthcare reform is changing the way health plans operate. From minimum medical loss ratio requirements to a renewed focus on population management, health plans more than ever must focus on objective business metrics.

MedInsight®, through its enterprise solutions, tools and consulting guidance, can help improve quality of care and reduce costs by standardizing and integrating large amounts of data into a single system. Milliman's portfolio of solutions provides the necessary expertise to transform raw data into healthcare business intelligence.

With MedInsight, you gain the ability to:


The MedInsight Analytic Platform is an industry-leading, ASP-deployed decision support system for health plan departments requiring claims-based reporting.


MedInsight provides easy-to-use tools designed to help health plans address specific problems. These single-component tools offer clients full control of loading data and running analyses.

MedInsight's HCG Grouper – designed to enable a client to group its claims data into Milliman’s Health Cost Guideline categories for powerful insight into cost and utilization metrics. The HCG Grouper helps underwriters with pricing of products, but is also valuable for analysis and trend management, as well as employer group reporting and medical management.

MedInsight Benchmarks – designed to generate benchmarks for a given population. The resulting set of benchmarks is tailored by geography, age, gender, and benefit design. Milliman's benchmark database of 40+ million members and 2+ billion claims line, combined with our unique adjustment factors, delivers the most meaningful benchmarks to health plans.

Chronic Condition Hierarchical Groups (CCHGs) – a clinical model of a population that ranks patients based on their chronic conditions and the impact of these conditions on treatment, utilization and cost. CCHGs help health plans decide how to most effectively use medical management resources by identifying which factors are really driving trend.


Milliman's technical, operational, data management, and actuarial consulting services provide deep analytical and technological expertise in the healthcare industry. We can help you leverage MedInsight to solve the most difficult and challenging business problems.

Learn more

If you are seeking to improve quality of care while containing costs, contact us to learn more about the wealth of expertise, data management, and analytic technology that Milliman offers. We would be happy to meet with your team to discuss your needs and our capabilities.

To receive more information, please contact Todd Fessler, MedInsight Sales and Marketing Director.

Learn More

To receive more information, please contact Todd Fessler, MedInsight Sales and Marketing Director.

Phone: +1 206.504.5516

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