Health solutions

Milliman health products

Alternative payment
Alternative payment
Alternative payment

ACO Care Management Impact Model

Model, establish, and measure medical management outcomes to achieve performance targets and make sound decisions.

ACA utilization and cost evaluation
ACA utilization and cost evaluation
ACO utilization & cost evaluation

ACO Insight

Get online access to dynamic, interactive claims reports and robust benchmarks for ACOs, updated monthly.

Claims data analytics
Claims data analytics
Claims data analytics

Bundled Payment Reporting Interface

Manage episodes of care under Medicare bundled payment models using the same logic and claims data employed by CMS.

Reserving and IBNP reserve estimation
Reserving and IBNP reserve estimation
IBNP reserve estimation

Claim Reserve Estimation Workbook (CREW)

Estimate reserves accurately with our powerful, yet simple tool for estimating "incurred but not paid" claim liabilities.

Benefit plan evaluation
Benefit plan evaluation
Benefit plan evaluation

CORAL

Estimate actuarial equivalent relative values for health plans based on variables such as copays, deductibles, and coinsurance.

Healthcare cost modeling
Healthcare cost modeling
Healthcare cost modeling

Dashboard for Research, Insight, and Validation of Experience (DRIVE)

Analyze historical data to inform policy decisions, validate encounter data, understand emerging experience, and more.

Healthcare risk adjustment
Healthcare risk adjustment
HEALTHCARE RISK ADJUSTMENT

EDGE ASSIST

EDGE ASSIST is Milliman's end-to-end managed service solution—from data ingestion and manipulation to the final submission and everything in between.

Healthcare cost modeling
Healthcare cost modeling
Healthcare cost modeling

Excess Product Suite

Improve the pricing and underwriting of medical excess products with a complete toolkit based on Milliman Health Cost Guidelines.

IFRS readiness and GASB75 compliance
IFRS readiness and GASB75 compliance
GASB 75 compliance

GASBhelp

Comply with GASB 75 requirements through easy-to-answer questions and step-by-step guidance.

Healthcare cost modeling
Healthcare cost modeling
Healthcare cost modeling

Health Cost Guidelines – Grouper

Benchmark utilization and costs by sorting claims data into Health Cost Guidelines™ (HCG) categories.

Healthcare cost modeling
Healthcare cost modeling
Healthcare cost modeling

Health Cost Guidelines Suite

Estimate expected claims costs and model healthcare utilization with Milliman’s Health Cost Guidelines™, an industry gold standard.

Employee communications
Employee communications
Employee communications

Health Plan Assist

Provide employees with a web-based tool that estimate out-of-pocket and premium costs for medical, dental, and vision plans.

ACA compliance and affordability
ACA compliance and affordability
ACA compliance & affordability

Healthcare Reform Dashboard

Give small and mid-size employers essential analysis needed for ensuring compliance and plan affordability under the Affordable Care Act (ACA).

Healthcare benchmarking
Healthcare benchmarking
Healthcare benchmarking

HECS & RBRVS for Hospitals

Compare and benchmark hospital contracts on a patient-severity adjusted basis.

Hospital performance analysis
Hospital performance analysis
Healthcare benchmarking

Hospital Operating Costs and Performance Benchmarks Report

Benchmark your operating costs and financial performance against peer facilities, as well as statewide and nationwide averages.

Hospital performance analysis
Hospital performance analysis
Hospital performance analysis

Hospital Performance Index

Analyze performance against national and regional best practices for strategic deployment of care management resources.

Healthcare cost modeling
Healthcare cost modeling
Healthcare cost modeling

Individual Medical Underwriting Guidelines (IMUGs)

Evaluate the expected relative cost of an individual applying for coverage with detailed ratings on more than 1,400 conditions.

Insurance risk assessment
Insurance risk assessment
Insurance risk assessment

Integrated Medical and Pharmacy Record Optimization and Validation Engine (IMPROVE)

IMPROVE combines your detailed claim and enrollment information with a proprietary algorithm to uncover opportunities to investigate undocumented or unsupported conditions or encourage enrollees to schedule annual wellness visits.

Insurance risk assessment
Insurance risk assessment
Insurance risk assessment

IntelliScript

IntelliScript combines industry-leading data and analysis to provide insurers the knowledge, tools, and insight to confidently assess risk.

Healthcare analytics
Healthcare analytics
Healthcare analytics

MedInsight

Adopt the healthcare industry’s leading platform for data warehousing and healthcare analytics.

Healthcare risk adjustment
Healthcare risk adjustment
Healthcare risk adjustment

Milliman Advanced Risk Adjusters

Manage Medicare, Medicaid, and commercial risk adjustment with our award-winning suite of tools and data.

Healthcare analytics
Healthcare analytics
Healthcare analytics

Milliman PRM Analytics

Strategically select and manage patients for the best opportunity to reduce risk with a predictive, scalable application.

Medicare advantage benchmarking
Medicare advantage benchmarking
Medicare Advantage benchmarking

Milliman MACVAT (Medicare Advantage Competitive Value Added Tool)

Evaluate relative values of Medicare Advantage program plans using a comprehensive, Excel-based tool.

Healthcare cost modeling
Healthcare cost modeling
Healthcare cost modeling

Milliman Health Trend Guidelines

Get accurate monthly information on healthcare expenditures and utilization for individuals enrolled in U.S. commercial insurance plans.

Medical underwriting
Medical underwriting
Medical underwriting

Milliman Medical Underwriting Suite

Improve the medical underwriting process with a comprehensive suite of products based on Milliman Medical Underwriting Guidelines.

Pharmaceutical claims analysis
Pharmaceutical claims analysis
Pharmaceutical claims analytics

MyRxConsultant

Compare contracted discount rates and savings with real-time pharmaceutical claims experience reporting.

Medical underwriting
Medical underwriting
Healthcare underwriting

WEBMugs

Enhance the efficiency and consistency of underwriters with a full-featured electronic underwriting application.

Medical underwriting
Medical underwriting
Healthcare underwriting

XLogic Rating System

Automate rating and underwriting functions such as new business, batch renewal, and workflow management.

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