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Objectivity matters. Today, more than ever.

Independent for over 70 years, Milliman delivers market-leading services and solutions to clients worldwide. With no agenda, other than getting it right.

Through a team of professionals ranging from actuaries to clinicians, technology specialists to plan administrators, we offer unparalleled expertise in employee benefits, investment consulting, healthcare, life insurance and financial services, and property and casualty insurance.

News

  • 14 September 2018 — Wall Street Journal
    Florence flood threat heightened by underinsured homeowners
  • 13 August 2018 — Captive.com
    Milliman named actuarial firm winner by this year’s U.S. Captive Review Awards
See All News

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Long-term care consulting

We offer unmatched depth and breadth of knowledge in long-term care.

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Expanding access to quality healthcare for a California community.

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Helping clients understand and navigate retirement risk

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Recent stories

  • An end to manufacturer rebates as we know them today?
  • Pathways to Success MSSP final rule: Winners and losers
  • Public Pension Funding Index, 4th Quarter 2018
  • Student loans and regulation: A bumpy ride for borrowers
Critical Point podcast

A Milliman podcast covering topics in health, benefits, and more

insightMilliman insight

All insightHealthcareEmployee Benefits and InvestmentInsuranceRisk Management and Financial Services
Medicaid managed care: The series
Medicaid managed care: The series
Pass-through payment guidance in final Medicaid managed care regulations
Pass-through payment guidance in final Medicaid managed care regulations
Medicaid risk-based managed care: Analysis of administrative costs for 2015
Medicaid risk-based managed care: Analysis of administrative costs for 2015

Medicaid

  • An end to manufacturer rebates as we know them today?

    By Deana Bell, Jennifer Carioto, Matthew Hayes | 15 February 2019

    The proposed rule to make drug manufacturer rebates no longer protected under the Anti-Kickback Statute has broad impacts to federally funded prescription drug programs, especially Medicare Part D.

  • Pathways to Success MSSP final rule: Winners and losers

    By Anders Larson, Cory Gusland | 14 February 2019

    This paper examines the Medicare Shared Savings Program’s (MSSP) final rule from the perspective of different accountable care organization (ACO) situations to help readers understand how the MSSP rule might affect different ACOs.

  • Changing the rebate game: A primer on the HHS proposed rule to shift drug rebates to POS

    By Maggie Alston, Carol Bazell, David R. Mike | 08 February 2019

    This paper discusses the implications of recently proposed rebate regulation to various Medicare Part D program stakeholders.

  • Seven key challenges for Medicaid states considering alternative payment models

    By Anders Larson, Rebecca L. Johnson, Zach Hunt | 29 January 2019

    This article focuses on some of the challenges that Medicaid payers (including states and managed care organizations) face when trying to establish alternative payment models with providers.

  • Critical Point Episode 8: Puerto Rico after the hurricane: Managing Medicaid in the face of a natural disaster

    By Jose Carlo | 14 January 2019

    Managing Medicaid in Puerto Rico after Hurricane Maria was part of Jose Carlo’s job, but it was also personal for the Milliman consultant.

  • Medicaid’s winding path through Institutions of Mental Disease

    By Christopher Kunkel, Catherine E. Lewis, Jie Savage | 19 December 2018

    The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act provides a simpler way for states to include Institutions of Mental Disease facilities in their fee-for-service and managed care delivery models—a state plan amendment.

  • Are you ready for New York State Medicaid value-based payment models?

    By Brett Friedman, Rebecca L. Johnson, Howard Kahn | 08 November 2018

    This paper provides a high-level overview of the New York State value-based payment models, discusses the opportunities and challenges for providers considering participation in them, and highlights the needs for sophisticated actuarial, financial, and legal expertise to address the inherent business, legal, and operational risks.

  • Approved Medicaid state directed payments: How states are using §438.6(c) Preprints to respond to the managed care final rule

    By Jim B. Pettersson, Ben Mori, Luke B.G. Roth, Jason A. Clarkson | 30 October 2018

    This paper provides a background on state directed payment arrangements based on our review of §438.6(c) “Preprints” and supporting documentation for arrangements approved by the Centers for Medicare and Medicaid Services as of August 15, 2018.

  • Medicaid managed care financial results for 2017

    By Jeremy D. Palmer, Christopher T. Pettit, Ian M. McCulla | 04 June 2018

    This report summarizes the calendar year 2017 experience for selected financial metrics of organizations reporting Medicaid experience under the Title XIX Medicaid line of business on the National Association of Insurance Commissioners annual statement.

  • Medicaid buy-in: Section 1332 Innovation Waivers, state options, and top ten considerations

    By Paul R. Houchens, Christine M. Mytelka, Susan Philip | 11 May 2018

    Medicaid buy-ins are currently getting states’ attention.

See More Articles

  • 19 April 2018

    How changing opioid prescribing patterns can impact risk scores

    This brief provides data on the decline in opioids prescribed to Medicaid expansion populations and the increased use of other non-opioid pain relief drugs.

  • 06 February 2018

    Enabling sustainable investment in social interventions: A review of Medicaid managed care rate-setting tools

    This report identifies practical strategies that states can deploy to support Medicaid managed care plans and their network providers in addressing social issues.

  • 20 December 2017

    Risk adjustment in CMS episode-based payment models: A resource guide

    This paper provides a high-level guide on risk adjustment within the broader scope of four Centers for Medicare and Medicaid Services episode-based payment models.

  • 13 September 2017

    Telehealth under alternative payment models

    Telehealth has the potential to boost the impact of population health management initiatives while improving access and convenience of healthcare delivery.

  • 07 July 2017

    Medicaid risk-based managed care: Analysis of financial results for 2016

    This report summarizes the calendar year 2016 experience for selected financial metrics of organizations reporting Medicaid experience under the Title XIX Medicaid line of business on the National Association of Insurance Commissioners annual statement.

  • 07 July 2017

    Medicaid risk-based managed care: Analysis of administrative costs for 2016

    This report summarizes the calendar year 2016 experience for selected administrative metrics of organizations reporting Medicaid experience under the Title XIX Medicaid line of business on the National Association of Insurance Commissioners annual statement.

  • 09 May 2017

    The American Health Care Act

    This paper explores the impacts of the May 4, 2017, version of the American Health Care Act as passed by the House on different markets and stakeholders of the healthcare system.

  • 10 March 2017

    Actuarial soundness under Medicaid block grants and per capita caps

    Actuarially sound capitation rates will remain critical to the long-term viability of Medicaid managed care programs.

Healthcare

  • Affordable Care Act research
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  • Healthcare reform reading list: From the ACA archives
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  • Medicare ACOs and Alternative Payment Models
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See all topics
  1. Healthcare
  2. Affordable Care Act research
  3. Healthcare costs
  4. Healthcare reform 2.0
  5. Healthcare reform reading list: From the ACA archives
  6. Long-term care insurance
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  8. Medical professional liability
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  28. Enterprise risk management
  • Featured videos

    • Medicaid - ThumbnailUnderstanding healthcare costs: Medicaid(4:44)
    • Story behind MMI - ThumbnailThe story behind the Milliman Medical Index(1:36)
    • Unbiased perspective - ThumbnailAn unbiased perspective on healthcare policy decisions(1:17)
    See all video
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About Milliman


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For more than seven decades, Milliman has combined technical expertise with business acumen to create elegant solutions for our clients. 

Today, we are helping companies take on some of the world's most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.


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