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Data-driven insight. Deep expertise. Transformative innovation. Since 1947, Milliman has delivered intelligent solutions to improve health and financial security.
A dynamic and growing market makes it more important than ever to offer competitive benefits and premiums to Medicare Advantage customers. Our comprehensive services include employer group pricing support, market and feasibility analysis, payment validation, and risk scoring.
Milliman has been helping plan providers creates successful Medicare Part D solutions since the program’s inception. Turn to us for retiree prescription drug plan review, creditable coverage testing, actuarial equivalence testing, and communications consulting.
Milliman healthcare consultants with clinical, IT, operational, compliance and marketing backgrounds, coupled with in-depth knowledge of Medicare programs, help you streamline operations, increase efficiency, and improve your services.
The CMS bid process is a gauntlet of complex regulations. Let Milliman help you find the right path forward for your Medicare plan, from Medicare Advantage to PACE. Our end-to-end support goes beyond initial submission to encompass desk review and audits.
Milliman is hosting a webinar series on Medicare topics that cover emerging trends in the 2021 Medicare Advantage market.
Over the last decade, ACOs have emerged as a major force in the way healthcare is delivered in this country.
How do responses differ by demographic characteristics?
This article reviews dental benefits provided within MA general enrollment plans using Centers for Medicare and Medicaid Services data, including trends in enrollment, benefits offered, and purchasing habits of beneficiaries.
Six important topics insurers should consider as they contemplate entering the Medicare Advantage market.
We cover the basics of offering employer group waiver plans (EGWPs) and the potential opportunities for health plans to enroll employer group retirees.
Why Medicare Advantage plans should focus continuously on achieving high star ratings.
COVID-19 creates a compelling environment for Medicare Advantage telehealth offerings
This article outlines the dental market landscape for Medicare Advantage plans in 2020 and explores trends that have emerged since 2018.
This paper provides insight into benefit and premium changes made alongside revenue changing due to a star rating change and measures the change in value added through benefits and premium changes provided to beneficiaries.
This paper explores the impact of the Part D Senior Savings Model on patient out-of-pocket costs.
Newly available product design options will require actuaries to develop new tools and processes in order to assist Medicare Advantage organizations in bid development.
This paper provides an in-depth technical evaluation of Direct Contracting, based on the Centers for Medicare and Medicaid Services request for applications, along with comparisons to its sister programs—Medicare Shared…
This report highlights key changes in member premiums and benefits for the 2020 Medicare Advantage (MA) market, as well as the contributing factors for, and the magnitude of, the increase in value added within the MA market…
What are the potential effects of prospective and retrospective assignment on key accountable care organization metrics under the Medicare Shared Savings Program?
This paper explores the various components of Medicare Advantage revenue, avenues Medicare Advantage organizations may explore to increase their Part C and Part D revenues, and key considerations for each approach.
What are the similarities and differences in the financial benchmark methodology between the Direct Contracting payment model and the Medicare Shared Savings Program?
Milliman’s integrated, customizable software solution for pricing claims based on Medicare allowable fees.
Evaluate relative values of Medicare Advantage program plans using a comprehensive, Excel-based tool.
Estimate expected claims costs and model healthcare utilization with Milliman’s Health Cost Guidelines™, an industry gold standard.
Adopt the healthcare industry’s leading platform for data warehousing and healthcare analytics.
Milliman’s Medicare Repricer software assigns Medicare-allowable fees to administrative claims data, allowing payers and providers to surface those fees in their enterprise data warehouse.
Leverage complete data, meaningful analytics, and Millman’s ACO expertise to analyze provider performance.
Deliver detailed, personalized Medicare plan price comparisons through a simple, web or API experience.
Manage Medicare, Medicaid, and commercial risk adjustment with our award-winning suite of tools and data.
Model, establish, and measure medical management outcomes to achieve performance targets and make sound decisions.
Get online access to dynamic, interactive claims reports and robust benchmarks for ACOs, updated monthly.
Manage episodes of care under Medicare bundled payment models using the same logic and claims data employed by CMS.
Answer key business questions with our in-depth understanding of risk-sharing contracts, advanced analytics, and modeling.
Identify areas of strength and gaps in performance with benchmarking reports that provide actionable advice.
Focus on making sound business decisions with help on all aspects of CMS bidding from submission to desk review to audit.
Manage risks and ensure profitability with a full range of analytical and actuarial services tailored to the needs of CCRCs.
Find and prioritize opportunities to improve your Star Rating--because today's performance is driving tomorrow's revenue.
We bring our customary rigor and objectivity to evaluating employer-sponsored health, wellness, and disease management programs.
As the global leader in consulting to Medicare Advantage, Milliman can help plans increase leads and membership in a cost effective and compliant manner.
Implement effective alternative payment strategies in collaboration with Medicare, including shared savings arrangements.
Access comprehensive Medicare Advantage services including employer group pricing support, feasibility analysis, payment validation, and more.
Improve care quality and cost efficiency with the leading independent Medicare experts.
Facilitate rate development, ensure feasibility, implement communications strategies, and more with dedicated Part D expertise.
Build quality MedSupp solutions and succeed in a growing, yet complex market.
Bring your offerings in line with regulations and improve care for mental health and addiction issues.
Reduce risk and increase revenue from the patient to the system level, including population health management and financial strategy.
A review of the Uniformity Flexibility benefits offered during the contract year…
Learn why Health Alliance Plan relies on the MedInsight Hospital Evaluation and…
We dig deep into rich Milliman MedInsight data to bring you insights you won&…
Join the dialogue about healthcare reform at the Healthcare Town Hall blog. From…
Do you know which members are likely to drive costs in the coming years? Learn…
Your decisions are only as good as your data. And your data is only as good as…
Ask the tough questions. We’re ready for them.