Network integrity, formulary competitive analysis, cost variation, value-based care analytics, provider risk monitoring, 1.12M formulary mappings, 2.6M providers, 6B+ negotiated rates, Medicaid drug utilization (9.3M rows) covering ~155M lives (Medicare + Medicaid combined), and 130+ compliance sources. The data dimensions payer teams need, all at from $199/month.
MMIT / Norstella
Formulary coverage, payer policy, patient access analytics
Milliman MedInsight
Payer data analytics (KLAS #1 2025), VBC, ACO analytics
IQVIA
Payer claims analytics, formulary impact, prescribing data
Cotiviti / Optum
Payment integrity, pre/post-payment accuracy
Consulting firms
Network adequacy analysis, rate benchmarking
Total per year
$400K–$2.3M+(dimensions we cover)Ask in plain English. Follow up to drill deeper. One conversation replaces multiple vendor dashboards.
Formulary Competitive Analysis (1.12M mappings)
1.12M drug–plan–tier mappings with prior authorization, step therapy, and quantity limits across plan-level prescribing. Compare your formulary coverage to every competitor plan. Find drugs with worse tier placement or more restrictions than alternatives. No MMIT contract needed for public formulary intelligence.
You ask
“Compare formulary coverage of Jardiance vs Farxiga across all plans”
Then follow up
“Which plans require prior auth for Jardiance but not Farxiga? How many members does that affect?”
“How has Jardiance’s formulary positioning changed over the past 2 years?”
Provider Network Intelligence
2.6M providers linked to 273K facilities via NPI taxonomy, specialty, address, hospital affiliations, group practice membership. Identify network gaps by geography and specialty. Verify credentials and affiliations. No separate vendor required for CMS public provider data.
You ask
“Which cardiologists within 30 miles aren’t in our network?”
Then follow up
“Of those out-of-network cardiologists, which are affiliated with in-network hospitals?”
“Show me network adequacy for cardiology across our three-county service area by ZIP code.”
Provider Compliance Monitoring (130+ sources)
Screen every network provider against 130+ enforcement and exclusion databases: OIG, SAM.gov, 50 state medical boards, FDA debarment, NPDB, CMS penalties, court records. Automated risk scoring A–F. Identify providers with new sanctions before they become a credentialing liability.
You ask
“Screen all 500 providers in our network, who has new flags?”
Then follow up
“Which flagged providers are high-volume for us? Show me their claims exposure.”
“Which state board actions were issued in the past 90 days for any of our network providers?”
Cost Variation Analysis
6B+ negotiated rates from 6,100+ hospital MRFs, by payer, procedure, billing code, and hospital. Compare what you pay to what other payers pay for the same procedure at the same facility. Identify where you’re overpaying and where you have leverage at renegotiation.
You ask
“How do our negotiated rates for knee replacement compare to the market?”
Then follow up
“Which hospitals are we paying above the 75th percentile for knee replacement? Show me the gap.”
“For our top 10 DRGs by spend, how do our rates compare to Blue Cross and Aetna at the same hospitals?”
Prescribing Intelligence
Prescribing data by provider, drug, and geography. Monitor prescribing patterns across your network. Identify high-cost prescribers, outliers on opioids or high-cost specialty drugs, and geographic variation in prescribing behavior.
You ask
“Which providers in our network prescribe the most opioids?”
Then follow up
“Compare our top opioid prescribers to state and national benchmarks. Who are the true outliers?”
“Which high-cost specialty drug prescribers in our network have the highest claims volume?”
Medicaid Drug Utilization (9.3M rows)
Medicaid drug spend and utilization across 50 states, covering ~85M Medicaid enrollees. Combined with plan-level prescribing data, Medistill now covers ~155M lives for drug spend analysis. Identify state-level access gaps, compare Medicare vs Medicaid formulary patterns, and benchmark drug utilization across government payers.
You ask
“Compare Medicaid vs Medicare drug spend for GLP-1 drugs across states”
Then follow up
“Which states have the highest Medicaid spend per enrollee on specialty drugs? Where are we an outlier?”
“For our highest-cost formulary drugs, how does Medicaid utilization compare to Medicare? Any access gaps we need to address?”
Provider Quality Monitoring
MIPS scores, CMS hospital star ratings, mortality and readmission rates, patient safety indicators, and HCAHPS scores across 6,100+ hospitals. Benchmark your network providers against peers. Identify underperformers before value-based contract negotiations.
You ask
“Which providers in our network score below the 25th percentile on quality?”
Then follow up
“For our value-based care contracts, which partner hospitals are trending down on quality over the past 3 years?”
“Show me MIPS scores for all primary care physicians in our network. Who are the bottom 10%?”
Drug Safety Monitoring
25M+ adverse-event reports with drug names, reactions, outcomes, and quarterly trends. Monitor safety signals for drugs on your formulary. Identify emerging risks before they become coverage or liability issues. Cross-reference with recalls and FDA enforcement actions.
You ask
“Are there growing safety signals for drugs on our formulary?”
Then follow up
“Compare the adverse event profile of our covered GLP-1 drugs. Which has more cardiac events?”
“Are there any new FDA enforcement actions or recalls for high-cost drugs on our formulary this quarter?”
Value-Based Care Analytics
Hospital financials from CMS cost reports, quality benchmarking, MIPS scores, ACO performance data, and risk scores. Monitor partner health system financial stability. Identify ACO partners trending toward distress. Benchmark performance across your value-based portfolio.
You ask
“Which ACO partners are trending toward financial distress?”
Then follow up
“Show me 5-year operating margin trends for our top 10 ACO partners. Any red flags?”
“Which value-based partners have the worst combination of declining quality scores and worsening financials?”
Not clean, SaaS-y queries. These are the messy, multi-domain questions a payer actually asks on Monday morning, each one normally means MMIT plus Milliman plus a claims warehouse plus a credentialing vendor.
“Which network providers had new OIG, state board, or NPDB activity in the past 30 days? Rank by our claims volume so we know which credentialing files to pull first.”
“How do our negotiated rates for the top 20 DRGs compare to UHC, Anthem, Cigna, and Aetna at the same hospitals? Which facilities are we most overpaying, and what’s the renegotiation upside?”
“Find all cardiologists within 20 miles of our network adequacy gaps. Which ones are affiliated with in-network hospitals but not contracted, and do any of them have compliance flags we’d need to resolve before adding?”
“Pull all serious adverse-event reports for the top 20 high-cost drugs on our formulary this quarter. Any signal accelerating? And is the current utilization concentrated in specific prescriber cohorts in our network?”
“Compare our formulary tier placement for GLP-1s to the 5 largest competing plans, and cross-reference with Medicaid utilization in the same states. Are we more restrictive, or more exposed?”
“Which network providers have both declining quality scores and new compliance flags? Those are our highest-risk credentialing renewals, I need the list before Friday.”
Medistill vs MMIT
MMIT leads on commercial formulary coverage and payer policy intelligence. We add prescribing data, provider compliance, cost variation, and drug safety they don't offer.
See full comparison →Medistill vs MedInsight
MedInsight is KLAS #1 for actuarial-grade claims analytics. We cover the dimensions they don't: formulary, provider compliance, drug safety, and price transparency.
See full comparison →Medistill replaces:
We don't replace:
Medistill covers the data and intelligence layer. It complements payer operational systems, not replaces them.
Pricing
Pro $199 / 500 credits · Business $499 / 1,500 credits · Unlimited $999 ($9,990/yr) · Team from $599/seat
Full access to all 2,000+ datasets. No per-query fees. 1 credit per entity processed.
No credit card required. Expires in 15 days.