Milliman today announced that its popular healthcare analytic platform, MedInsight, has been named a leader in the IDC MarketScape study, entitled “U.S. Payer Data Analytics 2015 Vendor Assessment, doc #HI255269, April 2015.” The company is one of eight vendors evaluated in the report.
MedInsight is positioned as a leader of this IDC MarketScape report—which provides an evaluation of the leading payer data analytic platforms—because of high satisfaction ratings from clients in terms of the high degree of flexibility, advanced analytics, and analytic tools supporting multiple types of users.
The report notes that Milliman’s strengths include the MedInsight Data Confidence Model—a methodology applied as a data warehouse is being created, and then leveraged on an ongoing basis for client data management—as well as the MedInsight benchmarking function that enables clients to benchmark organizational performance against Milliman’s health research database.
“The MedInsight mission is to provide analytic leadership and decision confidence to our clients. The fast-moving and uncertain nature of the healthcare industry demands a nimble and growing analytic platform,” said Kent Sacia, Milliman principal. “The IDC MarketScape report affirms the MedInsight team’s hard work toward that mission as we continuously commit to adding value to our clients.”
The IDC MarketScape vendor analysis model is designed to provide an overview of the competitive fitness of information and communications technology (ICT) suppliers in a given market. The research methodology utilizes a rigorous scoring methodology based on both qualitative and quantitative criteria that results in a single graphical illustration of each vendor’s position within a given market. The capabilities score measures vendor product, go-to-market, and business execution in the short term. The strategy score measures alignment of vendor strategies with customer requirements in a timeframe of three to five years. Vendor market share is represented by the size of the circles. Vendor year-over-year growth rate relative to the given market is indicated by a plus, neutral, or minus next to the vendor name.
For more information about Milliman’s MedInsight products, click here.
Milliman has announced the formal launch of a big data initiative. The MedInsight Data Confidence Model is a data management methodology that helps clients leverage concepts of big data for business performance improvement and transparency.
MedInsight is Milliman’s popular healthcare analytic platform used by over 200 health plans, employers, at-risk providers/accountable care organizations (ACOs), state governments, community health coalitions, and third-party administrators. Consistently recognized for its superior data integration and warehousing capabilities, MedInsight has continually developed and perfected its Data Confidence Model since 1997.
The MedInsight Data Confidence Model is applied as a client data warehouse is being created, and it is then leveraged on an ongoing basis for client data management. It includes both automated and manual processes to identify anomalies or irregularities in client data sets. Milliman aggregates data in innovative ways and compares the results against ranges of quality norms Milliman has developed over 15 years. Much like a lab test, each data metric in client data sets has a normal range. Results outside those norms often indicate a need for further investigation and/or remediation. The Data Confidence Model helps with common big data issues such as:
• Inconsistencies in how data was formatted and entered
• Relational integrity problems between components of the data
• Data volume consistency issues
• Duplication of data
• Integration and crosswalking of data from multiple data source providers
• Reasonableness of the metrics created by the system
Successful management of healthcare cost and quality for a single organization requires transparency into cost and quality data. In order to be effective, transparency requires integration of large volumes of high-quality and timely data—key components of the big data movement. The complexity of big data requires advanced data integration and quality assurance techniques in order for the underlying information to be reliable.
“MedInsight’s business has grown dramatically over the past four years, and we now maintain and process more than 15 billion healthcare records for 126 million healthcare members,” said Kent Sacia, Milliman Principal and MedInsight’s founder. “Supporting one of the largest healthcare claim data sets in the U.S. requires sophisticated data management techniques. Our MedInsight Data Confidence Model gives clients the confidence they need to rely on the data and information within their MedInsight data warehouses,” added Sacia.
The MedInsight Data Confidence Model is a critical component to help tackle the most difficult challenge of healthcare analytics—giving companies high confidence in making decisions by ensuring that the data that goes into the system is accurate.
A review of Milliman’s normative healthcare database indicates that nearly all of the recent increase in the cost of emergency rooms (ER) is due to significant increase in the prevalence of supporting services (laboratory, radiology, drugs, supplies, etc.) provided while in the ER.
My study included claim and enrollment data for commercial (employer-sponsored and individual) coverage from 2007 through 2011. It revealed an annual rate of increase in allowed per member per month (PMPM) costs for ER of slightly over 10%, which is substantially above the inflation rate during that same period of time. Interestingly, the actual number of ER cases per 1,000 covered members decreased very slightly during that period of time, while the unit costs for the individual services provided as part of a typical ER case only increased 1% annually.
So, what caused the double-digit annual total cost increase?
It appears to be almost solely caused by an increase in the number of services provided during an ER case. My study shows that a patient is likely to receive 50% more services, as part of their ER visit, in 2011 than in 2007. Of these additional services, 93% are related to lab, drugs, IV therapy, and radiology. Lab is most prevalent, with a 79% total increase in use from 2007 to 2011, but the unit cost of lab services decreased by about 25% during that same period. Combined drug and IV therapy prevalence rose 166% during the study period, but in this case, also experienced a marginal increase in unit cost. As a result, drug and IV therapy services explained nearly 35% of the total increase in ER costs. Finally, radiological services increased in prevalence per case by 22% during the period, and contributed 17% of the total increase in ER costs.
Further study might be necessary to understand the efficacy and value of the increase in these supporting ER services, and whether ER costs are continuing to increase in 2012 and in the future.
This article first appeared at Milliman MedInsight.
Healthcare IT News looks at cloud computing and healthcare. Here is an excerpt:
Whether called cloud computing or Software-as-a-Service (SaaS), the hosted model “certainly provides some potential for organizations dealing with both HIPAA 5010 and ICD-10 conversion efforts,” explains Kent Sacia, a principal and healthcare technology consultant at Milliman. “SaaS can provide a distinct advantage to organizations dealing with many changes, such as regulations. The model is lightweight to the end-user client and consolidates change requirements into functional models that are independent of the clients own IT processes”…
“As we see more core processing efforts achieved on the cloud, it is natural to offer these functional-based extensions,” Milliman’s Sacia explains. “I suspect we will see more cloud-based translation and simulation offerings for both providers and payers in the next 12 months.”