Healthcare costs

Population health management program development

---

• Strategies employers can consider to understand and combat opioid abuse and misuse

  By Barbara Culley, Christine Castle | 22 January 2019

  How can employers prepare for and address opioid abuse and misuse?

• Multiemployer Review: Know the specifics of your heath and welfare stop-loss policy

  By Sean Silva, David Stoddard | 21 January 2019

  As fiduciaries to health and welfare trusts, trustees must understand the details regarding their stop-loss carrier contracts in order to ensure the trust is receiving the most competitive price while also receiving sufficient protection against large claims in order to maintain sufficient trust assets.

• Computed tomography colonography less costly than colonoscopy for colorectal cancer screening of commercially insured patients

  By Judy Yee, Tia Goss Sawhney, Bruce S. Pyenson, Michele M. Berrios | 21 December 2018

  For colorectal cancer screening, does computed tomography have a cost advantage relative to optical colonoscopy for the commercially insured U.S. population?

• NADAC-plus: An emerging paradigm in pharmacy pricing?

  By Kevin P. Pierce, Andrea Sheldon | 14 November 2018

  This paper introduces national average drug acquisition costs (NADAC) and describes the opportunities and limitations of using NADAC as a basis for pharmacy pricing.

• Preference-sensitive surgical procedures for preference-sensitive conditions

  By Kathryn V. Fitch, Carol Bazell, Sumudu Dehipawala | 24 September 2018

  This paper focuses on 15 preference-sensitive surgical procedures that may be performed to treat certain preference-sensitive conditions that have surgical treatment options.

• The changing landscape of out-of-network reimbursement

  By David C. Lewis | 19 September 2018

  To avoid unfavorable outcomes, it is important to evaluate the methodology used for setting out-of-network reimbursement levels and to identify savings opportunities.

• Alternative payment model financial settlements: Preparing for and learning from the process

  By Christine Ferro, Maggie Alston, L. Daniel Muldoon, Pamela M. Pelizzari | 17 September 2018

  This paper focuses on alternative payment model reimbursement methodologies through the lens of the Centers for Medicare and Medicaid Services Oncology Care Model as an illustrative case study.

• Leveraging drug rebates for medical stop loss product innovation

  By Kevin P. Pierce, Thomas D. Murawski | 11 September 2018

  This paper explores potential innovations and key strategies for medical stop loss insurers.

• Fiscal year 2019 HRRP impact to hospitals

  By James Lucas | 11 September 2018

  This paper describes the changes that are coming with the Hospital Readmission Reduction Program and explores what the likely effects will be.

• International best practice benchmarks

  By Joanne Buckle, Tanya Hayward | 05 September 2018

  Milliman’s International Best Practice Benchmarks help quantify potentially avoidable admissions and beddays within a healthcare system to identify potential value opportunities.

See More Articles