Milliman Medinsight

Trust your data.

We know that your decisions are only as good as your data. And your data is only as good as your platform. That's why over 300 leading healthcare organizations across the U.S. trust the MedInsight platform to get the data right.

Pandemic induced medical loss ratio opportunities

Medical expenditures in the US were down steeply in 2020 due to deferred and forgone care associated with the COVID-19 pandemic, leading to historically low medical loss ratios (MLR) for insurers. For insurers, who must comply with state and federal minimum MLR regulations or pay costly rebates and remittances, this state of affairs brings with it both challenges and new opportunities for strategic investment.


Why MedInsight

MedInsight is powered by the MedInsight Data Confidence Model, which integrates, audits, and reviews every single piece of data, flagging inconsistencies and anomalies—so you can trust your data from the point of intake all the way to the general ledger.

We bridge the gap between cost management and care management with data warehousing, analytics, and benchmarks that help you rapidly learn and adapt.


What sets MedInsight apart?

Rock-solid data confidence

Data confidence is—or should be—the foundation of any healthcare analytics platform. We understand that fact in our bones, and it’s reflected in our platform. If you can’t trust the data, you can’t trust that you’ll make the right choices.

Scalability, power & efficiency

The cloud-native MedInsight platform lets you tap into virtually unlimited computing and hosting capacity, efficiently giving you power that scales up and down to meet your needs, in real time.

A smart, modern interface

MedInsight has an all-new, highly visual interface that helps you quickly and easily visualize trends and ask important questions. You can start with preset reporting and data configurations and customize for specific business needs.

Legendary benchmarks

MedInsight’s benchmarking capabilities leverage the widely respected Milliman Health Cost Guidelines (HCGs) and years of benchmark experience, so you can draw on vast empirical data—over 2.5 billion records and 75 million lives. These are the healthcare industry’s most coveted benchmarks.

Deep industry expertise

We’ve been in this business longer than any of our competitors, and we have a deep bench of expertise around developing and supporting cloud-based software.

Bottom-line trust

MedInsight is one of the most highly regarded data warehousing and healthcare analytics platforms. We’re trusted by over 300 health plans, employers, at-risk providers and ACOs, state governments, community health coalitions, and third-party administrators.


MedInsight products

Cost and utilization benchmarking

MedInsight Benchmarks

Leverages a core of vast empirical data, intimate local market knowledge for adjustment factors, and a wide number of plan and provider agreement variables.

Population health grouper

Chronic Condition Hierarchical Groups

Identifies cost trend drivers and effectively allocates disease and care management resources more accurately, using a unique clinical-care-based identification methodology.

Inpatient efficiency measurement

Guideline Analytics

Identifies inefficiencies in the way care is delivered at a population level using the same evidence-based guidelines that promote effective individual care.

Predictive risk modeling

Milliman Advanced Risk Adjusters

Offers a new approach to population health risk assessment with models that perform better, deliver more intelligent scoring, and offer greater clinical transparency.

Site of care grouper

Health Cost Guidelines Grouper

Enables you to process your own claims experience through a Health Cost Guidelines (HCGs)-based methodology so that you can evaluate cost and utilization and better price your products.

Low-value care identification

Health Waste Calculator

Identifies and quantifies wasteful healthcare spending and potentially unnecessary services to significantly improve healthcare efficiency and control costs.

Risk score accuracy

Conditions to Consider

Leverages collaborative filtering to identify missing or inaccurate diagnoses and provide better understanding of their impact on risk-based contracts as well as a more accurate risk adjustment.

Referrals and network leakage

Patient Flow

Explores and draws inferences between patients and healthcare providers, using sophisticated network analytics to create interactive geographic visualizations highlighting key insights such as network leakage.

Provider efficiency measurement


Offers provider contracting support by measuring provider efficiency via the assignment of relative value units (RVUs) to all services, including physicians and hospitals, DMEs and lab, and prescription drugs.


MedInsight solutions

Based on our deep industry experience, we've tailor-made suites of functionality and analytics to help you easily find the perfect balance of technology, expertise, and support your business requires.
MedInsight solutions

MedInsight Payer

Delivers payer-focused capabilities such as benchmarking cost and utilization metrics, population health management, employer group reporting, and many others.

MedInsight solutions

MedInsight Provider

Helps ACOs and at-risk providers with financial and clinical management, including benchmarking, population health management, and chronic condition analysis.

MedInsight solutions

MedInsight Multi-payer

Provides tools for managing All Payer Claims Database (APCD) initiatives, including data aggregation and integration, quality-based analytics, and public reporting.

MedInsight solutions

MedInsight Employer

A complete solution for analyzing unpaid claims liabilities, combining our industry-leading stochastic modeling tools with a robust suite of deterministic reserving tools and methods.

MedInsight solutions

MedInsight Government

Helps state governments proactively watch key healthcare trends to ensure that reimbursement rates are set appropriately, and managed Medicaid plans are performing.

Contact a MedInsight expert

Want to get more out of your data? We live for that. Let's talk about what's happening with your organization and find out how we can help.