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Healthcare analytics platform

Milliman Population Health Grouper

Milliman Population Health Grouper turns complex claims data into clinically meaningful insights. By grouping services into patient-centered cases, the solution helps organizations understand utilization patterns, identify drivers of healthcare spend, and support value-based care initiatives.

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THE CHALLENGE

Fragmented data limits insight

Healthcare organizations rely on claims data to guide strategy, but raw data lacks clinical context. Services appear as disconnected transactions, making it difficult to understand clinical care patterns or gaps. Existing tools often separate professional and facility claims or group data too broadly, limiting their value for population health management.

THE SOLUTION

Group data into meaningful cases

Milliman Population Health Grouper organizes claims into clinically relevant, case-based groupings. It combines all services related to a patient event and assigns each event to a single clinical segment. Teams can then understand care patterns, analyze subpopulations, and use healthcare analytics more effectively to improve utilization, cost, and outcomes.

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Milliman Population Health Grouper benefits

Improve population health management

Gain a complete view of patient populations and care patterns.

Identify drivers of healthcare spending

Break down costs by clinical segment and site of service.

Support value-based care strategy

Use insights to design programs that reduce cost and improve outcomes.

Strengthen utilization management

Detect high-use services and target opportunities for care optimization.

Enhance provider network management

Analyze leakage patterns and identify opportunities to optimize network performance.

Enable subpopulation analysis

Drill into specific conditions to uncover targeted improvement opportunities.

Milliman Population Health Grouper features

Group claims into patient-centered cases

Combine all services related to a particular healthcare encounter into a comprehensive event.

Apply clinically relevant segmentation

Assign cases to detailed clinical categories for actionable healthcare analytics.

Benchmark performance against peers

Compare utilization, cost, and outcomes using external benchmark datasets.

Deliver clean, analytics-ready output

Provide structured data files that support downstream reporting and modeling.

Integrate with existing Milliman solutions

Align with other Milliman tools to streamline implementation.

Support multiple use cases across teams

Enable analytics for medical economics, operations, population health, and contracting.

We’re here to help

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