Value-based care consulting and technology

Empowering success for ACOs and provider partners

Accountable care organizations (ACOs) manage complex risks to optimize financial and patient outcomes. Milliman can help you optimize strategy, increase efficiency, and achieve value-based performance targets. We deliver integrated healthcare analytics, technology tools, and consulting services built on unmatched expertise in value-based care.

Network management

Contract management

Financial performance monitoring

Program design and development

Care management workflow

Provider engagement and initiatives

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CONSULTING SERVICES

Transforming healthcare with leading ACO solutions and enriched, comprehensive data

ACOs require comprehensive solutions, addressing critical needs like network management, contract modeling, and financial performance monitoring. Our data-driven, value-based care consulting services help organizations manage risk, enhance patient care metrics, and reach operational excellence. Let our subject matter experts consult with you to develop solutions that deliver long-term success.

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Network management

Optimizing your provider network for value-based care

Value-based care contracts require a thoughtfully designed provider network. Milliman collaborates with ACOs to build high-performing networks, using provider-level insights that enhance engagement and contract outcomes. Additionally, we give ACOs custom technology solutions that meet their specific needs with:

Network modeling and development: Build efficient provider networks by leveraging advanced tools and data insights.
Provider benchmarking: Analyze provider performance to make informed decisions that drive better outcomes.
Participant list modeling: Improve contract performance by optimizing participation lists.

Learn more about Milliman services and solutions for network management.

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Contract management

Driving performance in risk-based contracts

Managing value-based care contracts can be overwhelming. You’re juggling financial risk, contract details, and performance metrics, all while trying to stay focused on patient care. That’s where Milliman comes in. We help simplify the process with tailored solutions that make contract modeling, settlement, and performance tracking easier. With our support, you get the insights and tools you need to manage contracts more effectively, so you can focus on what really matters—improving patient outcomes.

Contract modeling: Quantify expected financial results and understand risks with detailed contract models that inform the overall strategy.
Contract settlement: Streamline settlements and minimize financial risks by managing all aspects of risk-based contracts.
Consistent performance metrics: Understand performance drivers using cost and utilization metrics built on Milliman’s Health Cost Guidelines framework.
Bundled payments: Manage bundled payment arrangements that align with value-based healthcare goals and financial targets.

Discover Milliman services and solutions for contract management.

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Financial performance monitoring

Improving financial and operational outcomes

Achieving strong financial performance in value-based healthcare requires deep insights into cost drivers and opportunities for improvement. Milliman’s healthcare analytics for quality and performance improvement equips ACOs with the tools to identify cost-saving opportunities, understand utilization, and optimize financial outcomes. Our analytics help you manage financial risk and make informed decisions, helping your organization thrive in value-based healthcare initiatives.

Opportunity analysis: Identify key areas for financial improvement and optimize performance through targeted analysis.
Out-of-network and leakage management: Reduce financial risk by analyzing network leakage and improving care coordination.
Program management: Drive performance improvements by overseeing financial and quality initiatives through custom program management strategies.

Find out how Milliman technology and services can help your organization improve financial performance monitoring.

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Program design and development

Creating programs that drive results

Developing effective programs that balance cost, utilization, and care quality is critical for ACOs operating in a value-based healthcare environment. Milliman helps design targeted programs that achieve efficiency while improving patient outcomes. Our solutions are grounded in data and aligned with your organization’s goals, where interventions lead to measurable improvements in both cost management and care quality. Applications include:

Chronic condition and wellness programs: Design and implement initiatives that target chronic conditions and wellness, driving patient engagement and improving outcomes.
Utilization and referral management: Develop strategies to optimize utilization patterns and streamline referral processes for better care coordination.
Provider scorecards and outreach: Use scorecards to enhance provider performance and patient outcomes by delivering actionable insights.

Learn more about Milliman services and solutions that support program design and development.

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Care management workflow

Enhancing patient engagement and outcomes

Effective care management workflows close care gaps and improve patient outcomes. Milliman’s solutions enable ACOs to deliver personalized, patient-centered interventions that increase engagement and drive better health results. By focusing on targeted outreach and care coordination, we help your organization streamline care delivery and enhance overall efficiency via:

Care gap outreach: Target patients with specific care gaps to ensure timely interventions and improve adherence to measures under the Healthcare Effectiveness Data and Information Set (HEDIS).
Coordinated care management: Streamline care management processes to deliver more effective, individualized patient care.
Quality measurement and performance: Track care quality with benchmarks that drive continuous improvement in patient outcomes.

Improve the effectiveness of care management workflows—learn how Milliman services and technology can help.

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Provider engagement and initiatives

Boosting provider performance through actionable insights

Aligning provider performance with value-based care models requires precise performance metrics and benchmarking data. Milliman provides advanced analytics and consulting services that deliver targeted, data-driven strategies. These tools help your organization engage providers with clear performance benchmarks and evidence-based recommendations, driving improvements in care quality and achieving measurable results. The tools include:

Care gap prompts: Provide real-time prompts to help providers identify and close care gaps, improving patient outcomes.
Referral management support: Strengthen referral processes to keep patients within the network and improve care continuity.
Provider scorecards and benchmarking: Use detailed scorecards to help providers measure their performance and drive quality improvements based on industry benchmarks.

Learn more about how Milliman can help your organization drive provider engagement.

Empowering success for ACOs and provider partners

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Transforming healthcare with leading ACO solutions and enriched, comprehensive data

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Optimizing your provider network for value-based care

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Driving performance in risk-based contracts

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Improving financial and operational outcomes

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Creating programs that drive results

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Enhancing patient engagement and outcomes

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Boosting provider performance through actionable insights

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We’re here to help

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CHOOSE A LOCATION AND LANGUAGE

Transforming healthcare with leading ACO solutions and enriched, comprehensive data

Optimizing your provider network for value-based care

Driving performance in risk-based contracts

Improving financial and operational outcomes

Creating programs that drive results

Enhancing patient engagement and outcomes

Boosting provider performance through actionable insights

We’re here to help

CHOOSE A LOCATION AND LANGUAGE