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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
See All News

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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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  • 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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Provider

Key MACRA timeframes
Key MACRA timeframes

  • How to optimize partner providers’ performance using claims analytics

    By Dane Hansen, Noah Champagne | 10 December 2019

    As the prevalence of partnerships between payers and providers increases, it is critical for payers to monitor and track emerging experience and communicate these results to partner providers.

  • Financial sustainability of an integrated medical-behavioral primary care practice

    By Stephen P. Melek, Katie Matthews, Ally Weaver | 03 June 2019

    The state of Colorado has implemented behavioral healthcare in primary medical care settings under a Centers for Medicare and Medicaid Services State Innovation Model Award.

  • 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.

  • Hospital professional liability database: Key findings

    By Tony F. Bloemer, Rachel Soich, Timothy C. Vosicky | 11 December 2018

    An updated analysis of key findings from our hospital professional liability database.

  • 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.

  • 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.

  • 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.

  • Critical Point podcast, Episode 2: Alternative Payment Models 101

    By Pamela M. Pelizzari | 24 July 2018

    A discussion about alternative payment methods, bundled payment, ACOs, and more.

  • Is your provider organization maximizing its performance in value-based care programs?

    06 March 2018

    As the use of value-based reimbursement programs and the associated financial impact increases, it is important for providers to be educated on the mechanics of the program and to understand the analytical, operational, and clinical requirements to ensure success.

  • Insurance risk and its impact on provider shared risk payment models

    By Juliet M. Spector, Cory Gusland, Carol Kim | 12 January 2018

    A challenge facing providers and payers is to design shared risk payment models that incentivize providers to deliver efficient, high-quality care without assuming too much insurance risk from payers.

See More Articles

  • 22 December 2017

    ACA risk adjustment management: Going all-out

    This paper introduces the broader concept of risk management adjustment and highlights actions you can take to maintain its long-term success.

  • 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.

  • 23 October 2017

    Impacts of hurricanes on health outcomes and health insurance company operations

    From an operational and financial perspective, natural disasters can have significant effects on healthcare providers, insurers, and payers.

  • 02 October 2017

    Provider coding accuracy in commercial value-based contracts

    This paper explores various aspects of risk sharing as it pertains to value-based contracting for commercial lines of business.

  • 30 August 2017

    Regulatory capital strategies in an evolving health insurance landscape

    As the relationship between health plans and healthcare providers continues to evolve, this landscape creates new financial opportunities for health plans managing regulatory capital.

  • 17 August 2017

    Health plan considerations for growing direct-to-consumer genetic testing

    This white paper looks at the progression of direct-to-consumer genetic testing and the current demand and growth, discusses industry concerns, and suggests activities for health plans to consider.

  • 21 March 2017

    Provider price transparency

    This paper explores what price transparency means in the healthcare market, the forces driving the need for price transparency, challenges and uses of price transparency, and potential ways in which transparency can be improved for the benefit of consumers and also to be more effective in reducing overall healthcare costs.

  • 21 February 2017

    Building a successful value-based payer contracting strategy

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

Healthcare

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See all topics
  1. Healthcare
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  11. Provider
  12. Employee Benefits and Investment
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  24. Risk management
  25. Solvency II
  26. Telematics
  27. Risk Management and Financial Services
  28. Enterprise risk management
  • Featured videos

    • CHOMP 239Aspire health plan: How Monterey is reinventing healthcare(6:23)
    • Medicaid - ThumbnailUnderstanding healthcare costs: Medicaid(4:44)
    • Story behind MMI - ThumbnailThe story behind the Milliman Medical Index(1:36)
    See all video
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About Milliman


Our Company

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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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