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QualCare selects MedInsight from Milliman for health plan, ACO analytic software

QualCare to use MedInsight for plan analytics and ACO strategy


News provided by

Milliman, Inc.

Feb 26, 2013, 10:00 ET

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SEATTLE, Feb. 26, 2013 /PRNewswire/ -- Milliman, Inc., one of the premier global consulting and actuarial firms, today announced that QualCare, Inc. has implemented MedInsight® as its data warehousing and claim analytic platform.  QualCare will use MedInsight to help with a variety of analytic reporting needs including health plan analysis and ACO reporting.

"QualCare chose the MedInsight system from Milliman due to its superior functionality in analyzing plan costs, benchmarking, and provider quality and efficiency measurement," said Karthik Ganesh, COO at QualCare.  "In addition, the MedInsight team has enhanced the product to keep up with health reform requirements. There are a number of key features in MedInsight that will help QualCare execute on its ACO strategy," Ganesh added.

QualCare will utilize many components of the MedInsight system including cost and utilization analysis and benchmarking, incurred but not reported (IBNR) and reserves analysis, trend analysis and forecasting, and provider profiling. "QualCare is committed to high quality, patient-oriented care. Our ability to leverage vast amounts of data through MedInsight analytics will enable us to gain deeper insight on quality and efficiency opportunities that benefit our members," said Ganesh.

"QualCare is the largest provider-sponsored managed care organization in New Jersey, and we are honored that MedInsight was selected and implemented as its claim analytic and ACO reporting system," says Todd Fessler, Milliman Principal and MedInsight Sales & Marketing Director. "QualCare has clear goals for executing on their ACO strategy as well as continual performance measurement against industry benchmarks. The capabilities of the MedInsight system are a very solid fit with these requirements," added Fessler.

MedInsight is the popular analytic platform that is used by over 175 health plans, employers, at-risk providers, state governments, community coalitions and third party administrators.  Consistently recognized for its superior data integration and warehousing capabilities, MedInsight has been enhanced with a variety of new functionality that is making it easier for clients to analyze data in the new era of healthcare reform.

For more information about Milliman's MedInsight products, go to http://www.medinsight.milliman.com.

About Milliman
Milliman is among the world's largest providers of actuarial and related products and services. The firm has consulting practices in healthcare, property & casualty insurance, life insurance and financial services, and employee benefits. Founded in 1947, Milliman is an independent firm with offices in major cities around the globe.  For further information, visit milliman.com

About QualCare
QualCare, Inc. is New Jersey's largest provider-sponsored Managed Care Organization that offers self-funded PPO, HMO network, point of service (POS) network, and open access health plans; third party administration (TPA) services, provider network access, care management services, and a workers' compensation product. QualCare also provides ACO consultative services and infrastructure.

Headquartered in Piscataway, New Jersey, QualCare services over 800,000 members and is owned by 16 non-profit hospitals and physician-hospital organizations, with a clientele that spans health systems, unions, local governments, school boards, and other commercial employers. QualCare's network covers over 100 acute, specialty and rehabilitation hospitals, as well as over 20,000 physicians and other ancillary providers at 33,000 locations across NJ, PA & NY.

SOURCE Milliman, Inc.

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