Health solutions
Mental & behavioural health
The industry experts in mental and behavioural health
Milliman consultants are well versed in the intricacies of mental and behavioural health coverage and legislation and can provide guidance to clients on cost, utilisation, and more.
Milliman mental & behavioural health solutions
Mental health parity compliance
We test health plan compliance with the quantitative and nonquantitative requirements of MHPAEA. Quantitative testing checks that financial requirements and quantitative treatment limits for mental health/substance use disorder benefits are no more restrictive than predominant levels for medical/surgical benefits. We also test compliance with nonquantitative treatment limits, including care management processes.
Policy analysis and special topics research
We evaluate and forecast the potential impact of current or future mental health and substance use disorder policy as well as quantify the prevalence, variation, or impact of emerging behavioural health challenges.
Integrated medical-behavioural healthcare
We evaluate the economic impact of integrated care, including developing financial support and staffing models, calculating return on investment, and researching the impact of medical and behavioural comorbidities on total cost of care.
Program design and evaluation
We analyse outcomes of population health, disease management, substance use treatment, and other types of behavioural programs with the goal of identifying areas of improvement in program design and delivery.
Opioid crisis research and support
We research aspects of the opioid crisis in the U.S., including prescribing patterns, ER usage, comorbidities, and excess costs. We also support and evaluate programs and other responses to the opioid epidemic.
Predictive modelling
We develop models to predict underdiagnosed or undermanaged mental health and substance use disorders from prior healthcare utilisation patterns, demographics, prescription drug use, and other diagnoses.
Financial projections
We perform analyses such as projecting health costs and utilisation by service category, evaluating budgets and rate adequacy, and estimating cost savings from programs or other interventions.
Development of alternative payment models
We design elements of risk management for behavioural healthcare providers in their contracting efforts, including but limited to capitation rates, risk sharing, incentive payments, and performance guarantees.
Fee schedule evaluation
We analyse provider fee schedules for behavioural providers over time and compare them to area-specific and national benchmarks.
Cost and utilisation benchmarking
We evaluate behavioural healthcare costs and utilisation metrics by service category against area-specific and national carrier data.
Rate setting and negotiation support
We perform financial analyses to project future costs and evaluate the adequacy of behavioural healthcare rates.
Grant application support
We develop healthcare utilisation and cost projections for baseline periods and intervention periods to demonstrate cost effectiveness of new initiatives for payer contracts or government entities.