MedInsight Payer data analytics software

MedInsight Payer Solution

Designed just for payers

We’ve worked with payer organizations for over 20 years, and we developed MedInsight Payer specifically to tackle the challenges they face every day:

• Data collection, aggregation, integration, quality
• Performance benchmarking
• Cost and utilization analysis
• Care management analysis
• Employer group reporting
• Risk management and optimization
• Population health
• Value-based care 

MedInsight Payer accepts a variety of data resources and formats. It leverages the MedInsight Data Confidence Model to ensure data accuracy and integrity, including:

• 100+ automated audits
• 60+ stringent data tests
• Quick data refreshes that average three days
• Milliman peer review: a supplemental, manual review of your data by a trained Milliman data professional
• Custom-defined fields and dimensions
• Ability to store up to 600 data elements

Our analytics engine can integrate multiple complex databases while flagging inconsistencies and anomalies, so you can feel confident from the point of intake to the general ledger.

Benchmarking for performance assessments

MedInsight Payer leverages Milliman-engineered benchmarks tailored to the specific population being analyzed. These benchmarks are based on factors such as age, gender, geography, benefit design, and health risk adjustment, and they leverage the same benchmarking database used by Milliman’s highly respected actuaries.
We trend the benchmarks in order to be current and reflective of medical inflation, and you can choose to compare whole populations broadly or drill down to fine detail.

Powerful analytics and visualization

MedInsight Payer includes some of Milliman’s most powerful analytic engines and visualization tools.

The Health Cost Guidelines Grouper (HCG Grouper) can help your organization more efficiently track utilization. You can use the HCG Grouper to create population cost models, define claims service categories, and categorize specific utilization counts.

The Cube Browser can produce results from large sets of aggregate or summary data in seconds. MedInsight Query Express® allows you to drill down further into detailed, claim-line-level data for queries on specific populations or claims experiences, allowing you to comb through hundreds of millions of claim lines in seconds.

Customizable dashboards help you create powerful visuals that tell stories and reveal insights in your data. MedInsight uses one of the premier open-source libraries for advanced graphing, so our features always stay up to date.

Support you can count on

The MedInsight customer service team was ranked #1 by healthcare IT research firm KLAS (“2019: Best in KLAS” for Payer Quality Analytics).

In addition to providing industry-leading support, MedInsight Learning gives you a one-stop shop for training videos, documentation, a constantly updated knowledge base, and everything you need to know about using MedInsight Payer.