Healthcare Solutions
Risk adjustment
Balancing the scales
In the continued quest to improve healthcare coverage, risk adjustment has become a standard part of the insurance marketplace. Milliman consultants provide real-world expertise for complex risk adjustment applications and all aspects of the complexities of pricing and population management, including under health exchange risk adjustment programs.
Milliman risk adjustment solutions
The industry’s most precise risk adjuster
Milliman Advanced Risk Adjusters ® (MARA) is a suite of risk adjustment tools for commercial, Medicaid, and Medicare population risk analysis. MARA predictive models offer unique perspectives with individual risk scores by health service categories, making them perfectly suited for budgeting, pricing, underwriting, risk stratification, and many other health insurance applications.
We know risk adjustment better than anyone
As a full service actuarial and consulting firm, Milliman brings a comprehensive understanding of the application of risk adjustment and predictive modeling to complex healthcare applications. Whether you require risk adjustment tools, strategic advice, or customized models, knowledgeable consultants and actuaries are always available to help design and deliver successful solutions.
Dig deeper into your healthcare data
MedInsight® combines vital patient information into a single, comprehensive reporting system that can accurately generate performance metrics on demand for insurers, employers, and Medicaid agencies.
Milliman risk adjustment insight
Milliman risk adjustment products
MedInsight
Nutzen Sie die branchenführende Plattform für Data Warehousing und Analytik im Gesundheitswesen.
Milliman Advanced Risk Adjusters
Manage Medicare, Medicaid, and commercial risk adjustment with our award-winning suite of tools and data.
Integrated Medical and Pharmacy Record Optimization and Validation Engine (IMPROVE)
IMPROVE combines your detailed claim and enrollment information with a proprietary algorithm to uncover opportunities to investigate undocumented or unsupported conditions or encourage enrollees to schedule annual wellness visits.
EDGE ASSIST
EDGE ASSIST is Milliman's end-to-end managed service solution—from data ingestion and manipulation to the final submission and everything in between.
Milliman ACO Builder
Leverage complete data, meaningful analytics, and Millman’s ACO expertise to analyze provider performance.