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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.

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  • 27 March 2018 — The Seattle Symphony
    Seattle Symphony, musicians announce four year contract extension
  • 07 February 2018 — Reuters
    Reuters: What happened yesterday was just a very small blip
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We offer unmatched depth and breadth of knowledge in long-term care.

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Recent stories

  • 2018 Corporate Pension Funding Study
  • Market commentary, 1st Quarter 2018
  • Milliman FRM Insight: March 2018 Market Commentary
  • Monthly Benefit News and Developments, April 2018
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Beating fantasy sports with predictive analytics

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All insightHealthcareEmployee Benefits and InvestmentInsuranceRisk Management and Financial Services
Hedge Cost Index
An Overview of the Bundled Payments for Care Improvement Advanced Model
Healthcare reform 2.0
Developing alternative payment models under MACRA
Pass-through payment guidance in final Medicaid managed care regulations
The future of Medicare's episode-based payments

Medicare ACOs and Alternative Payment Models

  • The exclusion of some nursing facility visits from MSSP assignment has potential unintended consequences

    By Tia Goss Sawhney, Kathryn V. Fitch, Cory Gusland | 16 April 2018

    This article describes the changes in the historical benchmarks and performance expenditures for a number of Medicare Shared Savings Program accountable care organizations and also explains the possible impact of these changes.

  • An Overview of the Bundled Payments for Care Improvement Advanced Model

    By Samuel Bennett, Pamela M. Pelizzari | 13 March 2018

    This paper outlines the major provisions of the newly announced Bundled Payments for Care Improvement Advanced model.

  • Medicare Part D DIR: Direct and indirect remuneration explained

    By Deana Bell, Tracy A. Margiott | 29 January 2018

    As direct and indirect remuneration continues to increase, it is important for Medicare Part D sponsors to consider the effect of potential regulatory changes on plans’ bottom lines and operations.

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

    By Samuel Bennett, Thomas D. Snook | 20 December 2017

    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.

  • Addressing challenges in the transition to value-based care and alternative payment models: A case study in the Oncology Care Model

    By Maggie Alston, Christine Ferro, L. Daniel Muldoon, Pamela M. Pelizzari | 11 December 2017

    This paper highlights the key aspects of alternative payment model payment methodologies and uses the Centers for Medicare and Medicaid Services Oncology Care Model as a case study to illustrate these concepts.

  • Developing alternative payment models under MACRA

    By L. Daniel Muldoon, Pamela M. Pelizzari | 01 December 2017

    This paper explores key clinical and financial considerations that need to be addressed in a robust alternative payment model proposal.

  • The future of Medicare's episode-based payments

    By L. Daniel Muldoon, Pamela M. Pelizzari | 21 November 2017

    Given the many drivers of change in payment and service delivery reform recently, providers that have been working to redesign their care delivery to align with the value-based payment goals of Medicare are asking themselves if value-based payment is here to stay and whether it is worth the continued investment.

  • Telehealth under alternative payment models

    By Susan Philip | 13 September 2017

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

  • Building a successful value-based payer contracting strategy

    By David V. Williams, David M. Liner, Colleen Norris | 21 February 2017

    This paper introduces three pillars to optimize a provider’s performance with value-based contracts: transparency, stability, and control.

  • Medicare Advantage opportunities in innovation

    By Courtney R. White | 22 September 2016

    The Centers for Medicare and Medicaid Services is the latest payer to investigate value-based insurance design by offering an option through the Medicare Advantage program.

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  • 16 August 2016

    Advanced APMs and Qualifying APM Participant status

    This paper explores the definition of an Advanced Alternative Payment Model (Advanced APM) , how providers can qualify to be paid under the provisions of the Advanced APM track instead of under the Merit-Based Incentive Payment System, and why that might be desirable.

  • 11 July 2016

    Are you ready for the new world of value-based reimbursement?

    Value-based reimbursement contracting and payment can lead to long-term success if the appropriate resources are engaged.

  • 02 September 2015

    New “insurance” regulations on providers participating in alternative payment arrangements

    A recent growing trend has been to shift insurance (utilization) risk from payers to providers through alternate payment contracts (APCs) in an effort to align financial compensation with performance and financially penalize providers if certain financial and quality thresholds are not met.

  • 08 July 2012

    The two Medicare ACO programs: Medicare Shared Savings and Pioneer – risk and actuarial differences

    The key financial and risk differences between MSSP and Pioneer.

  • 07 February 2012

    Pioneer ACOs: Quantifying risks and identifying opportunities

    Risks associated with Pioneer ACOs and potential strategies for controlling costs.

  • 26 January 2012

    ACO gain/loss sharing

    A framework for allocating savings within an accountable care organization.

  • 30 December 2011

    Evaluating bundled payment contracting

    Bundled payments are an increasingly popular alternative to fee-for-service reimbursement.

  • 22 April 2011

    ACOs beyond Medicare

    Individual providers are likely to join larger systems, many of which will find partnering with a health plan most advantageous.

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  • 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)
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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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