Milliman works with health plans to navigate all of Medicaid's complexities. With our unparalleled actuarial expertise, we help plans understand their populations, evaluate capitation rates, and optimize provider relationships.

Our consultants apply many different methods and approaches for setting actuarially sound capitation rates. We use both fee-for-service and managed-care encounter data, depending on the situation and availability of data. Our goal is to help our clients develop realistic scenarios that meet their needs.

We also allow clients to focus on making sound business decisions by understanding all facets of the bidding process. We monitor shifting CMS regulations, freeing clients from worry about bids being rejected because of technicalities. Our support extends beyond bid submission, through desk review and audit.

We work with many different diagnostic risk adjusters, including Chronic Illness and Disability Payment System, Medicaid Rx, DxCG, Adjusted Clinical Groups, and the CMS Hierarchy for Condition Categories.

With experience working on state, national, and international healthcare reform, Milliman can give sound advice on the expected impact of the ACA for providers, insurers, and governments.

We have the expertise and creativity to come up with new paradigms, such as our development of the Wisconsin Family Care needs-based risk adjustment mechanism, the first of its kind in the industry.