HEALTH SOLUTIONS
Medicare
Making Medicare work for all concerned
Milliman Medicare solutions
Medicare Advantage
A dynamic and growing market makes it more important than ever to offer competitive benefits and premiums to Medicare Advantage customers. Our comprehensive services include employer group pricing support, market and feasibility analysis, payment validation, and risk scoring.
Medicare Part D
Milliman has been helping plan providers creates successful Medicare Part D solutions since the program’s inception. Turn to us for retiree prescription drug plan review, creditable coverage testing, actuarial equivalence testing, and communications consulting.
Operational consulting
Milliman healthcare consultants with clinical, IT, operational, compliance and marketing backgrounds, coupled with in-depth knowledge of Medicare programs, help you streamline operations, increase efficiency, and improve your services.
Bid development, desk review, and audit support
The CMS bid process is a gauntlet of complex regulations. Let Milliman help you find the right path forward for your Medicare plan, from Medicare Advantage to PACE. Our end-to-end support goes beyond initial submission to encompass desk review and audits.
All things Medicare
Milliman is hosting a webinar series on Medicare topics that cover emerging trends in the 2021 Medicare Advantage market.
Milliman Medicare insight
Healthcare changes in the Inflation Reduction Act
From negotiated drug prices to Medicare Part D redesign, our research and analysis break down the law’s implications for plan sponsors, health plans, and pharmaceutical manufacturers.
Milliman Medicare products
Medicare Reference Pricer
Milliman’s integrated, customizable software solution for pricing claims based on Medicare allowable fees.
Milliman MACVAT (Medicare Advantage Competitive Value Added Tool)
Evaluate relative values of Medicare Advantage program plans using a comprehensive, Excel-based tool.
Health Cost Guidelines Suite
Estimate expected claims costs and model healthcare utilization with Milliman’s Health Cost Guidelines™, an industry gold standard.
MedInsight
Nutzen Sie die branchenführende Plattform für Data Warehousing und Analytik im Gesundheitswesen.
Medicare Repricer
Milliman’s Medicare Repricer software assigns Medicare-allowable fees to administrative claims data, allowing payers and providers to surface those fees in their enterprise data warehouse.
Milliman ACO Builder
Leverage complete data, meaningful analytics, and Millman’s ACO expertise to analyze provider performance.
Medicare Suggest
Deliver detailed, personalized Medicare plan price comparisons through a simple, web or API experience.
Milliman Advanced Risk Adjusters
Manage Medicare, Medicaid, and commercial risk adjustment with our award-winning suite of tools and data.
ACO Care Management Impact Model
Model, establish, and measure medical management outcomes to achieve performance targets and make sound decisions.
ACO Insight
Get online access to dynamic, interactive claims reports and robust benchmarks for ACOs, updated monthly.
Bundled Payment Reporting Interface
Manage episodes of care under Medicare bundled payment models using the same logic and claims data employed by CMS.
Milliman Medicare services
Advanced analytics for accountable care organizations
Answer key business questions with our in-depth understanding of risk-sharing contracts, advanced analytics, and modeling.
Benchmarking
Identify areas of strength and gaps in performance with benchmarking reports that provide actionable advice.
Bid development, desk review & audit support
Focus on making sound business decisions with help on all aspects of CMS bidding from submission to desk review to audit.
CCRC consulting services
Manage risks and ensure profitability with a full range of analytical and actuarial services tailored to the needs of CCRCs.
CMS Star Rating Improvement
Find and prioritize opportunities to improve your Star Rating--because today's performance is driving tomorrow's revenue.
Health, wellness, and disease management ROI
We bring our customary rigor and objectivity to evaluating employer-sponsored health, wellness, and disease management programs.
Healthcare plans marketing services
As the global leader in consulting to Medicare Advantage, Milliman can help plans increase leads and membership in a cost effective and compliant manner.
Medicare ACOs
Implement effective alternative payment strategies in collaboration with Medicare, including shared savings arrangements.
Medicare Advantage (Part C)
Access comprehensive Medicare Advantage services including employer group pricing support, feasibility analysis, payment validation, and more.
Medicare consulting services
Improve care quality and cost efficiency with the leading independent Medicare experts.
Medicare Part D
Facilitate rate development, ensure feasibility, implement communications strategies, and more with dedicated Part D expertise.
Medicare Supplement insurance
Build quality MedSupp solutions and succeed in a growing, yet complex market.
Mental Health Parity & Addiction Equity Act
Bring your offerings in line with regulations and improve care for mental health and addiction issues.
Value-based reimbursement strategy
Reduce risk and increase revenue from the patient to the system level, including population health management and financial strategy.