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HEALTH SOLUTIONS

Medicare

Making Medicare work for all concerned

OVERVIEW

Milliman Medicare solutions

Medicare Advantage

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Medicare Part D

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Operational consulting

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Bid development, desk review, and audit support

Bid development, desk review, and audit support

Webinar series

All things Medicare

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Insight

Milliman Medicare insight

White Paper

Understanding oncology step therapy in Medicare Part D

We offer some key considerations for life science companies on navigating the complexity of oncology step therapy in Medicare Part D.

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White paper

Chronic condition special needs plans: 2026 market landscape and future considerations

We discuss five key takeaways from our analysis of the Medicare Advantage C-SNP market, and offer considerations for 2027 and beyond.

White paper

Key insights into 2026 Medicare Advantage D-SNP landscape

We discuss historical and current growth, recent policies impacting the plans, and key insights.

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Article

Demystifying the TEAM target price: A practical walkthrough of target prices in CMS’s Transforming Episode Accountability Model

We clarify how CMS calculates target prices under its new payment model to help participating hospitals make budgeting and staffing decisions.

White paper

Milliman MedIntel Part D trend insights Q4 2025

As Medicare drug costs rise, we highlight some trends among the key populations and by product.

White Paper

Shaping senior care: Trends in Medicare Advantage benefits and coverage from 2023 to 2026

We analyze how the prevalence and richness of mandatory supplemental benefits have evolved for general enrollment Medicare Advantage plans.

White paper

Approaches to lower Medicare Part D out-of-pocket costs for beneficiaries with limited income

With the sunset of two Medicare demonstration programs, states and Part D plans need to evaluate other strategies to lower cost sharing for affected individuals.

White paper

Medicare Advantage institutional special needs plans: 2026 market landscape and future considerations

Institutional special needs plans: We offer four key takeaways on the market landscape and the future for this specialized type of Medicare Advantage offering.

White Paper

State of the 2026 Medicare Advantage industry: Dual-eligible plan valuation and selected benefit offerings

We highlight changes in value-added and key-benefit trends in the Medicare Advantage market from 2025 to 2026, focusing on Dual-Eligible Special Needs Plans.

White paper

2025 Medicare FFS catheter billing anomalies and ACO implications

We detail the Medicare fee-for-service catheter billing anomalies observed during 2025 and discuss the implications for affordable care organizations.

landmark legislation

Healthcare changes in the Inflation Reduction Act

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RELATED PRODUCTS

Milliman Medicare products

Benchmarking
HEALTHCARE UNIT COST INSIGHTS

Milliman Commercial Reimbursement Benchmarks

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Claims data analytics
Claim pricing

Medicare Reference Pricer

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Medicare advantage benchmarking
Medicare Advantage benchmarking

Milliman MACVAT (Medicare Advantage Competitive Value Added Tool)

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Healthcare cost modeling
Healthcare cost modeling

Health Cost Guidelines Suite

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Healthcare analytics
Healthcare analytics

MedInsight

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Claims data analytics
Claims data analytics

Medicare Repricer

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Healthcare analytics
ACO analytics

Milliman ACO Builder

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ACA utilization and cost evaluation
Medicare plan selection solution

Medicare Suggest

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Healthcare risk adjustment
Healthcare risk adjustment

Milliman Advanced Risk Adjusters

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Alternative payment
Alternative payment

ACO Care Management Impact Model

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Claims data analytics
Claims data analytics

Bundled Payment Reporting Interface

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RELATED SERVICES

Milliman Medicare services

Resources

Milliman Medicare resources

Article

Medicare Advantage Uniformity Flexibility benefit offerings

A review of the Uniformity Flexibility benefits offered during the contract year 2019 plan year.

Video

Optimizing hospital partnerships

Learn why Health Alliance Plan relies on the MedInsight Hospital Evaluation and Comparison System (HECS) tool for hospital contracting.

BLOG

Milliman Healthcare Analytics Blog

We dig deep into rich Milliman MedInsight data to bring you insights you won’t find anywhere else, plus updates on the state of regulatory affairs.

Issue Brief

Identifying high-cost members

Do you know which members are likely to drive costs in the coming years? Learn how you can find out—before it’s too late to do anything about it.

We’re here to help