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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

  • 19 February 2019 — Captive Review
    The 2018 Captive Review Power 50
  • 14 September 2018 — Wall Street Journal
    Florence flood threat heightened by underinsured homeowners
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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

  • See the forest for the trees
  • Remaining a vibrant domicile
  • Milliman FRM Market Commentary: December 2019
  • Monthly Benefit News and Developments, December 2019
Critical Point podcast

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

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MACRA
MACRA: The series
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Medicare Part D member profitability by pharmacy channel
Medicare Part D member profitability by pharmacy channel

Medicare

  • Changes to 2020 Medicare Plan Finder

    By Michelle Klein, Matt Kranovich | 15 October 2019

    This paper highlights several key changes to Medicare Plan Finder— and potential unintended consequences— and offers suggestions as to how those changes could potentially affect Medicare Advantage Organizations.

  • Bonus or penalty? Medicare provider payments are now adjusted based on quality metrics

    By Christopher Kunkel, Mike Hamachek | 16 September 2019

    What happened in the first year of Merit-Based Incentive Payment System reporting?

  • Early thoughts on the Primary Care First model

    By Raheel Sohail, Cory Gusland, Daniel Henry | 22 August 2019

    This paper explores key model features of the Center for Medicare and Medicaid Innovation’s Primary Care First, a new voluntary payment model focused on primary care.

  • A new Part D benefit design? Prescription Drug Pricing Reduction Act proposes major changes to Part D

    By Joanna Amend, Samantha J. D’Anna, Dustin J. Grzeskowiak, Justin Harris, Matthew Hayes | 15 August 2019

    This article provides an overview of the provisions in the Prescription Drug Pricing Reduction Act of 2019 and the effects on Medicare Part D stakeholders.

  • The real-world Medicare costs of Alzheimer disease: Considerations for policy and care

    By Bruce S. Pyenson, Charles Steffens | 28 June 2019

    This article compares total Medicare-covered (allowed) costs of patients with Alzheimer disease with the risk-adjusted costs of beneficiaries without dementia over their last years of life, using claims data.

  • Medicare Advantage enrollment: Growth expectations for new organizations

    By Kelly S. Backes, Julia M. Friedman | 26 June 2019

    This paper analyzes historical enrollment experience for parent organizations new to the Medicare Advantage market from 2007 to 2018.

  • Model change impact on the Medicare Advantage 2020 RxHCC risk scores

    By Adrian L. Clark, David Koenig | 23 May 2019

    This paper summarizes the changes in member risk scores resulting from the revised Medicare Part D risk score model for payment year 2020.

  • Removal of safe harbor affects EGWPs

    By Stephen Kaczmarek | 02 May 2019

    A proposed rule from the Department of Health and Human Services would revise the safe harbor protection in Medicare Part D that currently allows pharmaceutical manufacturer rebates to be paid after the point-of-sale and start requiring such rebates to be credited against the drug’s point-of-sale price.

  • Taking on Medicare Part D risk: Provider perspective

    By Matthew J. Kramer, Simon Moody, Michael T. Hunter | 12 April 2019

    This article summarizes the key issues providers need to consider before taking on Part D risk, an increasingly common ask from Medicare Advantage organizations, and highlights some of the complexities and common barriers observed when advising provider clients on their strategies for Part D risk.

  • Hang on tight! Why maintaining a zero-dollar MA-PD premium plan is worth the effort

    By Bradley J. Piper, Mary L. Gabe | 08 April 2019

    What happens to membership in Medicare Advantage-Prescription Drug plans with a zero-dollar premium when a premium is added?

See More Articles

  • 05 April 2019

    Impact of offsetting midyear list price and rebate reductions in Medicare Part D

    The structure of the Medicare Part D program produces interesting, and sometimes counterintuitive, financial outcomes when drug list prices are decreased and rebates are eliminated.

  • 25 March 2019

    Medicare Advantage Uniformity Flexibility benefit offerings

    A review of the Uniformity Flexibility benefits offered during the contract year 2019 plan year to provide insight into the market dynamics regarding this new benefit design.

  • 08 March 2019

    What’s in the Part D Payment Modernization Model Request for Application: More questions than answers

    With less than one month to respond, many details unknown, and multiple impending changes to the Part D program, the Part D Payment Modernization Model’s Request for Applications leaves more questions than answers.

  • 22 February 2019

    Pathways to Success MSSP final rule: Financial benchmark

    This paper discusses the changes to the financial benchmark methodology that measures the gross savings or losses of an accountable care organization under the Medicare Shared Savings Program.

  • 19 February 2019

    The Medicare Advantage Value-Based Insurance Design Model: Overview and considerations

    This research brief describes the Value-Based Insurance Design model for Medicare Advantage organizations (MAOs) and explores key considerations for eligible MAOs considering participation in the model.

  • 15 February 2019

    An end to manufacturer rebates as we know them today?

    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.

  • 14 February 2019

    Pathways to Success MSSP final rule: Winners and losers

    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.

  • 12 February 2019

    LTSS services in Medicare Advantage Plans

    This article addresses how the Medicare Advantage marketplace responded in 2019 to the Centers for Medicare and Medicaid Services’s expanded definition of primarily health-related benefits, including which supplemental benefits plans are offering and where these benefits are offered.

Healthcare

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See all topics
  1. Healthcare
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  5. Healthcare reform reading list: From the ACA archives
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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)
    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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