Milliman Transparent
Benchmarking price transparency data
Interpreting results using CMS’s Medicare fee schedules vs. Milliman GlobalRVUs
By Will Fox and David McManus
09 October 2024
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PRICE TRANSPARENCY ANALYTICS
Milliman Price Transparency Solutions for Payers and Providers
Demystify payer and provider contractual pricing data for better transparency across the industry
Milliman Transparent applies both Medicare and Milliman Global Relative Value Units (GRVU Medicare) to the transparency data as unit price benchmarks. While they are mostly aligned, these two benchmarks will occasionally yield significantly different results. This paper helps Transparent users understand the differences between these two benchmarks and why GRVU Medicare better accounts for the case mix and severity of a commercial population. The paper includes discussion of such topics as:
- Discharges and diagnosis-related group relative weight
- Calculating Medicare allowed using GRVUs
- Comparing traditional versus Milliman GRVUs
- Using GRVUs for estimating resources for delivering outpatient services