MedInsight Value-Based Care Platform

What is the MedInsight Value-Based Care Platform?

The Milliman MedInsight Value-Based Care (VBC) Platform is a modular, actuarial grade analytics solution built for accountable care organizations (ACOs), provider groups, and integrated delivery systems operating under value-based and risk-bear arrangements.

The platform consolidates claims, clinical, third-party data into a unified analytics foundation grounded in trust, transparency, and validation, enabling organizations to confidently track performance, manage variation, and stand behind results as financial accountability increases. Built on Microsoft Azure, the platform supports enterprise-scale analytics modernization while helping organizations manage contract performance, quality outcomes, and total cost of care across value-based programs.

The MedInsight VBC Platform offers organizations:

• Trusted, attributed performance insight: Milliman actuarial methodologies, benchmarks, and data validation help ensure consistent, defensible performance measurement organizations can rely on across contracts and populations.
• Modular growth aligned to VBC maturity: Start with core performance visibility and expand capabilities as risk arrangements, organizational needs, and analytic sophistication evolve.
• Provider-focused analytics depth: Purpose-built to support provider and ACO use cases, including attribution, provider performance, cost and utilization analysis, quality measurement, and value-based contract management.
• Enterprise consistency across teams: A shared analytics foundation enables finance, clinical, population health, and operations teams to work from the same performance story.

Backed by Milliman expertise, the MedInsight VBC Platform brings together validated analytics, industry benchmarks, and integrated data so organizations can identify performance drivers, benchmark results, and prioritize actions that improve outcomes while protecting margin, using standardized dashboards, reporting, and advanced analysis tools where deeper insight is required.

What key use cases and capabilities does the MedInsight VBC Platform support?

• Contract development: Design and model value-based contracts using actuarial-grade benchmarks and assumptions, giving finance leaders confidence to negotiate terms that support sustainable risk and defensible margins.
• Contract settlement: Produce settlement-ready financial reconciliations across payers and contracts, enabling earlier variance detection, fewer disputes, and faster realization of shared savings.
• Network leakage and referral management: Identify provider-level leakage patterns and referral opportunities to retain care within high-value networks and protect margin before performance year close.
• Revenue enhancement: Improve contract revenue through advanced risk adjustment, coding performance insights, and prospective identification of under-documented clinical conditions, before benchmarks are finalized.
• Provider scorecard: Deliver clear, provider-level performance scorecards that connect cost, quality, and utilization to specific, actionable improvement opportunities tied directly to VBC outcomes.
• Performance management: Monitor financial and utilization trends in near real-time, enabling proactive course correction against VBC targets while the performance year is still open.
• Financial health: Assess contract and population-level financial performance across multiple arrangement to identify margin drivers, surplus risk, and downside exposure in one unified view.
• Provider workflow management: Enable operational follow-through by embedding insights directly into workflows, ensuring accountability, engagement, and measurable performance improvement.