MedInsight

MedInsight, a Milliman company, provides healthcare data analytics software that has served over 300 payers and Accountable Care Organizations (ACOs) since 1997. The platform specializes in aggregating and normalizing claims data across multiple sources, enriching it with county-level benchmarks, risk adjusters, and clinical groupers through their proprietary MedInsight Data Confidence Model.

The company offers three primary platform variants: Value-Based Care for ACOs and providers, Payer for health plans, and Risk Adjustment for clinical documentation improvement. Their analytics suite includes applications for contract performance tracking, AI-powered insights, employer group reporting, and clinical decision support. Notable recent achievements include helping ACO clients achieve $658 million in Medicare Shared Savings Program savings in 2024.

MedInsight has earned Best in KLAS recognition for six consecutive years in the Payer Data Analytics Platforms category, demonstrating consistent customer satisfaction. The platform processes data from commercial, Medicare Advantage, and Medicare Shared Savings sources, providing unified analytics across disparate claims systems.

Choose MedInsight when your organization needs enterprise-grade healthcare data analytics with proven value-based care performance. The platform excels for organizations managing multiple claims data sources who require sophisticated benchmarking, risk stratification, and population health capabilities without building internal infrastructure.

Expect a managed analytics service backed by Milliman's actuarial expertise rather than just software licensing. The platform delivers normalized, enriched data with monthly refreshes, comprehensive training programs, and dedicated client support that multiple testimonials highlight as responsive and transparent.

MedInsight operates exclusively in healthcare, with 28 years focused specifically on health plan and value-based care analytics. The platform incorporates healthcare-specific intellectual property including clinical groupers, episode treatment groups, risk adjustment methodologies (HCC, RxHCC), and quality measures aligned with HEDIS, NCQA, and CMS requirements.

The company serves the full healthcare ecosystem including commercial payers, Medicare Advantage plans, Medicaid managed care organizations, ACOs, physician-hospital organizations, state government purchasers, and self-insured employers managing population health.

The ideal MedInsight client is a regional health plan, ACO, or integrated delivery network with 50,000+ covered lives managing value-based care contracts. Organizations should have multiple claims data sources requiring normalization, dedicated analytics teams who can leverage advanced reporting tools, and strategic priorities around risk adjustment, quality measurement, or Medicare Shared Savings Program optimization.