Healthcare Data Analytics
Milliman Medicare Market Intelligence
Proven in unlocking market access potential for leading organizations
Unsampled data – all members, all claims
Medicare lives
As little as 2 weeks of data lag
Specialized modules and more to come
MedIntel combines 100% unsampled CMS claims data with Milliman's actuarial expertise to deliver real-time Medicare market intelligence.
An interactive web-based solution for competitive Medicare market insights
Select your business to see how MedIntel’s specialized modules solve your most pressing business challenges and inform strategic decisions
Module: Pharmacy Network Discounts
Module: Emerging Part D Claims
Module: Member Migration
Module: Adherence
Built on CMS’s Research Identifiable Files (RIF), our platform provides 100% unsampled claim- and member-level data covering the entire Medicare population. Part D prescription drug event (PDE) records and traditional Medicare claims are available with as little as two weeks of lag, while Part C encounter data provide comprehensive Medicare Advantage (MA) insights.
Our actuarial team enriches the raw CMS data with proprietary methodologies and industry-standard benchmarks to deliver actionable intelligence:
Enhancements:
Compare your plan performance against every market participant using CMS-compliant risk scores and Milliman's proven methodologies. Make confident strategic decisions backed by 75-plus years of actuarial expertise and complete market data.
Negotiate from a position of strength with comprehensive reimbursement benchmarks across all competitors. Identify opportunities for improved contract terms across pharmacy types, drug categories, and 20-plus dimensions—leading to millions in potential annual savings.
Monitor real member migration patterns across the entire Medicare landscape. Quantify financial impact of enrollment changes by analyzing prior-year utilization and cost profiles for every cohort, protecting your high-value membership.
Generate custom reports at any level—national trends to individual pharmacy—using 100% unsampled data, not statistical samples. Transform weeks of manual analysis into minutes of data-driven insights.
Explore complete claims data through intuitive dashboards tailored to your role. Generate custom reports filtered by plan sponsor, member cohort, therapeutic class, prescriber network, or any combination of many other available dimensions.
Model rebate structures and formulary positioning scenarios using your actual claims data. Evaluate financial impacts of drug placement decisions with confidence, leveraging both plan-specific and market-wide utilization patterns.
Enterprise security meeting the highest compliance standards, plus dedicated actuarial consultants to extract maximum value from day one. Unlike with commodity analytics tools, you get Milliman expertise built into every implementation—with 2–4-week deployment and ongoing consultation from Medicare actuaries.
Whether you’re a Part D plan sponsor, PBM, retail pharmacy chain, specialty pharmacy, or life sciences company, our modules are designed specifically for your analytical needs and business objectives within the Medicare marketplace.
Compare your rates against every competitor PBM and chain using complete Part D data. Analyze by network status, dispensing channel, drug category, and 20+ dimensions to identify immediate savings opportunities and strengthen your negotiating position.
Key Insights You'll Gain:
Track prescription volume trends and market share across pharmacy chains, PBMs, and plan sponsors with complete data. Segment by geography, individual drugs, and channel to identify competitive threats and expansion opportunities.
Key insights you’ll gain:
Identify whether your experience diverges from market norms with near-real-time Part D data. Drill from organization to plan to NDC level with comprehensive cost metrics to inform strategic decisions.
Key Insights You'll Gain:
Analyze medical utilization trends using complete Parts A, B, and C data categorized by Milliman’s Health Cost Guidelines™ (HCG). Benchmark your MA plan against competitors and traditional Medicare to identify significant cost management opportunities.
Key insights you'll gain:
Identify which members you gained, retained, or lost—nd where they came from or went to. Quantify enrollment changes by analyzing prior-year utilization and cost profiles to protect your high-value member segments.
Key Insights You'll Gain:
Optimize CMS Stars performance with actionable adherence intelligence. Identify intervention opportunities at contract, prescriber, and pharmacy levels using near-real-time data to improve MPR for the three key Stars measures.
Key Insights You'll Gain:
Identify which customers fill at your locations and where their remaining scripts go. Benchmark share-of-wallet against competitors to develop targeted strategies that increase loyalty and capture additional prescriptions.
Key insights you'll gain:
Join leading Medicare organizations using MedIntel to make data-driven decisions every day. Ready to transform your Medicare market insights?