Milliman MedInsight®, a leading provider of healthcare data and analytics, has officially announced the launch of a comprehensive, end-to-end risk adjustment workflow solution.
According to certain reports, this new Milliman MedInsight® Risk Adjustment Platform arrives on the scene bearing an ability to leverage industry expertise and AI-driven technology, all for the purpose of achieving improved risk workflow and clinical documentation. More on the same would reveal how such a powerful solution makes it possible for healthcare organizations to confidently track performance, and at the same time, better manage financial risks.
Talk about the whole value proposition on a slightly deeper level, we begin from the promise of unified health records from all major national networks and direct APIs to ensure no critical information is missed.
Next up, we have the claims-medical record integration, which will come in handy to bridge the gap between claims and medical records. The idea behind doing so is to streamline workflows, scale up documentation accuracy, and enhance response tracking.
Another detail worth a mention here is rooted in in the prospect of seamless system integration with existing systems and workflows to enable easy storage, retrieval, and future access of queries and reports.
“Risk adjustment accuracy is becoming increasingly important as Medicare ACOs (including those participating in Medicare Shared Savings Program (MSSP) and ACO REACH) and Medicare Advantage (MA) plans continue to grow. These programs rely on accurate risk assessment to ensure that health plans and providers are fairly compensated for the care they deliver,” said Noah Champagne, Milliman Principal and Consulting Actuary.
Then, there is the potential for enhanced coding compliance, something which can tread up a long distance to identify isolated errors versus systemic provider issues, and therefore, realize accurate coding and targeted training.
Hold on, we still have a few bits left to unpack, considering we haven’t yet touched upon Milliman’s proactive care identification facility. This facility, on its part, empowers users to quickly pinpoint beneficiaries, who may benefit from greater care (e.g., in-home care visits), in a pursuit of improving star ratings and health outcomes.
We also haven’t touched upon the availability of comprehensive insights into provider quality, financial performance, and risk levels down to the individual NPI. These insights are markedly powered by the Milliman ACO Builder and Milliman Medicare Advantage Network Intelligence (MANI), along with quarterly lagged Medicare national data.
Rounding up highlights would be the solution’s assortment of peer comparison tools. These tools can effectively leverage Milliman’s ability to access comprehensive Centers for Medicare and Medicaid Services (CMS) data to gain a competitive edge.
“The Risk Adjustment Platform enables us to fully achieve our vision of tackling the complexities and coordination challenges between providers and patients,” said Marcos Dachary, Chief Market Strategist of Milliman MedInsight Payer Solutions. “The combination of MedInsight’s actionable intelligence and data enrichment platform with clinical and documentation workflows will create a comprehensive solution that is truly unique and unmatched in the market. This marks a significant step forward in helping customers meet regulatory requirements and enhancing the quality of care they provide to their patients.”
Founded in 1988, Milliman MedInsight’s rise up the ranks stems from its comprehensive suite of analytics and data solutions, a suite which allows organizations to leverage healthcare data for informed decision-making, as well as improved clinical and financial outcomes. The company is presently focused on providing actionable insights into healthcare utilization, costs, quality, and performance. Milliman’s excellence in what it does can also be understood once you consider it is trusted, at present, by more than 300 payers, providers/ACOs.
