State Medicaid agencies could be asked to demonstrate how State Directed Payments compare to Medicare rates under proposed rule CMS-2449-P, but the path to doing so is not always clear. Our experts walk through the proposed changes and what you can leverage to get ahead, including the Medicare Repricer.

Our Milliman experts provide strategies for identifying and capturing opportunities in your claims data and provide info on how the Market Average Reimbursement Benchmarks (MARB) empowers you to benchmark your rates against the market, spot opportunities, and negotiate better reimbursement.

In this webinar, we will help you understand percent of Medicare and its role in the commercial healthcare market, and provide case studies.

Our experts discuss what falls out when using Medicare fee schedules.

In this presentation, you’ll learn about the best practices and tools available to compare networks, as well as the strengths and weaknesses of each approach.

We estimate the national commercial reimbursement payment rates increasing in 2024 to 190% of Medicare fee-for-service rates, up from 188% last year.

Ever wondered how CMS sets the Medicare Advantage (MA) benchmarks and how payments flow from CMS to health plans and from health plans to providers?

For healthcare stakeholders reporting percent-of-Medicare results, the scope and payment amounts should be clearly defined and appropriate for the comparison goals.