Milliman MedInsight is KLAS #1 for payer analytics in 2025, with actuarial-grade claims analytics, risk adjustment, and VBC performance measurement. Medistill covers the dimensions they don't: formulary analytics, provider compliance across 130+ sources, drug safety from 25M+ adverse-event reports, and price transparency from 6B+ negotiated rates, all at from $199/mo.
Their strength
Actuarial claims + VBC analytics
Our strength
Formulary + compliance + drug safety
What we add
130+ sources + 6B+ rates + 25M+ adverse-event
Honest positioning
MedInsight wins on actuarial-grade claims analytics. If your primary needs are proprietary claims-based cost benchmarking, HCC risk adjustment, episode grouper analysis, or actuarial-grade VBC performance measurement, MedInsight is the better choice, Medistill does not have proprietary claims data. Where Medistill wins is formulary coverage analysis, provider compliance screening, drug safety signal monitoring, and CMS price transparency data that MedInsight doesn't offer. These are genuinely complementary, not competing, tools for most payer analytics teams.
| Feature | | Milliman MedInsight |
|---|---|---|
| Core approach | Payer intelligence layer, Medicare + Medicaid drug data (~155M lives), plan formulary coverage, acquisition-cost benchmarks, provider compliance, cost variation, prescribing analytics, drug safety | Actuarial-grade payer analytics platform (KLAS #1 2025), proprietary claims analytics, risk adjustment, VBC performance measurement, cost and utilization benchmarking, predictive modeling |
| Proprietary claims analytics | Not available, Medistill does not process proprietary payer claims | Core strength, actuarial-grade proprietary claims analytics with risk adjustment, episode groupers, cost and utilization benchmarking across a large multi-payer claims database |
| Risk adjustment modeling | Not available, Medistill does not perform actuarial risk adjustment or HCC risk score modeling | Advanced risk adjustment including HCC risk scores, risk stratification models, and predictive modeling for population health management |
| VBC performance measurement | Hospital quality benchmarking, MIPS scores, ACO performance data from CMS public reporting. Monitor partner quality trends and financial stability. | Flagship strength, proprietary VBC performance measurement including quality metric calculation, cost attribution, shared savings modeling, and ACO analytics |
| Cost & utilization benchmarking | 6B+ negotiated rates from hospital MRFs for procedure-level rate benchmarking. CMS cost reports for hospital-level financial trending. | Proprietary cost and utilization benchmarks from claims data, by service category, region, specialty, and plan type. Actuarial-grade benchmarks used in contract negotiations. |
| plan formulary coverage (1.12M mappings) | 1.12M drug–plan–tier mappings with prior authorization, step therapy, and quantity limits across all plans. Competitive formulary positioning and tier benchmarking. | Not a primary offering, MedInsight focuses on claims-based analytics rather than formulary coverage data |
| Medicaid drug utilization | 9.3M rows across 50 states (2024–2025), prescriptions, units, spending by NDC and state. Compare Medicare vs Medicaid patterns. | Medicaid claims available through proprietary data; MedInsight has broader claims access |
| drug acquisition costs | 1.6M rows of pharmacy acquisition costs by NDC, updated weekly. Net cost benchmarking. | Not a primary offering |
| Commercial formulary coverage | Not available, Medistill covers plan-level + Medicaid utilization, not commercial | Not a primary offering, formulary data is outside MedInsight’s core claims analytics scope |
| Provider compliance screening (130+ sources) | Screen providers against 130+ enforcement databases: OIG, SAM.gov, 50 state boards, FDA debarment, NPDB, CMS penalties, court records. Automated risk scoring A–F. | Not available, provider compliance and credentialing screening is outside MedInsight’s scope |
| Negotiated rates (6B+ rates) | 6B+ negotiated rates from 6,100+ hospital MRFs by payer, procedure, billing code, and hospital. Compare what you pay vs. what other payers pay at the same facility. | Not available, MedInsight uses claims data for cost benchmarking rather than CMS price transparency MRF data |
| Drug safety monitoring (25M+ reports) | 25M+ adverse event reports with quarterly trends. Monitor safety signals for formulary drugs. Cross-reference with FDA recalls and enforcement actions. | Not available, pharmacovigilance and adverse event monitoring are outside MedInsight’s scope |
| Prescribing intelligence | prescribing data by NPI, volume, cost, drug breakdown by provider, specialty, and geography. Identify outliers on opioids and high-cost specialty drugs. | Prescribing patterns available through claims-based analytics; more comprehensive than public plan-level data but requires proprietary claims access |
| Provider network intelligence | 2.6M providers at 273K facilities, specialty, address, affiliations, NPI taxonomy. Network gap analysis by geography and specialty. | Provider profiling available through claims analytics; focus is on cost and utilization patterns rather than network completeness |
| Hospital quality benchmarking | CMS Hospital Compare: star ratings, mortality, readmissions, patient safety indicators, HCAHPS across 6,100+ hospitals with peer comparisons | Quality metrics available through claims-based measurement; VBC quality reporting is a core use case |
| Hospital financial trending | CMS cost reports: revenue, operating margin, beds, discharges, case mix index, FTE, 5–7 year history per facility. Monitor ACO partner financial stability. | Financial analytics available through claims data; cost reports not a primary data source |
| Litigation history (10M+ cases) | 10M+ court cases with full opinion text. Litigation history by provider or hospital, malpractice trends, and citation lookup. | Not available |
| Predictive modeling | Not available, Medistill does not offer actuarial predictive models or population health risk stratification | Advanced predictive modeling including readmission risk, ER utilization prediction, and population health stratification models |
| Interface | Ask in any language, get answers in any language. Works on desktop and mobile. Generate custom reports, share with anyone, schedule recurring analyses. API for automation. | Enterprise analytics platform with dashboards, custom reporting, data warehouse integrations, and dedicated implementation support |
| Pricing | from $199/mo unlimited queries | $50K–$300K+/yr |
Use MedInsight if:
You need actuarial-grade proprietary claims analytics with HCC risk adjustment and risk stratification, episode grouper analysis and cost attribution for VBC contracts, actuarial-quality cost and utilization benchmarks by service category and region, predictive modeling for readmission risk or ER utilization, or comprehensive VBC performance measurement with shared savings calculation. MedInsight's KLAS #1 ranking reflects genuine depth in proprietary claims analytics that external sources cannot replicate.
Use Medistill if:
You need plan formulary coverage benchmarking across 1.12M mappings (not available from MedInsight), provider compliance screening across 130+ enforcement sources, negotiated rate benchmarking from 6B+ hospital MRFs, drug safety signal monitoring from 25M+ adverse-event reports, provider quality benchmarking from CMS Hospital Compare, or litigation history across 10M+ court cases, all at from $199/mo with no contract required.
Use both if:
Keep MedInsight for actuarial claims analytics, risk adjustment, and VBC performance measurement where their proprietary data is irreplaceable. Add Medistill for formulary analytics, compliance screening, price transparency benchmarking, and drug safety monitoring, dimensions MedInsight does not cover, at from $199/mo alongside your existing MedInsight contract.
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.