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HEALTH SOLUTIONS

Medicare

Medicare

Making Medicare work for all concerned

In the ever-changing world of Medicare, it pays to have an experienced strategic partner to help you navigate new payment models, regulations, and market shifts. We have the data, methodologies, and in-market experience to help you succeed.

OVERVIEW

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.

RELATED PRODUCTS

Milliman Medicare products

Medicare Advantage benchmarking

Milliman MACVAT (Medicare Advantage Competitive Value Added Tool)

Evaluate relative values of Medicare Advantage program plans using a comprehensive, Excel-based tool.

Healthcare cost modeling

Health Cost Guidelines Suite

Estimate expected claims costs and model healthcare utilization with Milliman’s Health Cost Guidelines™, an industry gold standard.

Healthcare analytics

MedInsight

Adopt the healthcare industry’s leading platform for data warehousing and healthcare analytics.

Healthcare risk adjustment

Milliman Advanced Risk Adjusters

Manage Medicare, Medicaid, and commercial risk adjustment with our award-winning suite of tools and data.

Alternative payment

ACO Care Management Impact Model

Model, establish, and measure medical management outcomes to achieve performance targets and make sound decisions.

ACO utilization & cost evaluation

ACO Insight

Get online access to dynamic, interactive claims reports and robust benchmarks for ACOs, updated monthly.

Claims data analytics

Bundled Payment Reporting Interface

Manage episodes of care under Medicare bundled payment models using the same logic and claims data employed by CMS.

RELATED SERVICES

Milliman Medicare services

Resources

Milliman Medicare resources

Article

Medicare Advantage Uniformity Flexibility benefit offerings

A review of the Uniformity Flexibility benefits offered during the contract year 2019 plan year.

Video

Optimizing hospital partnerships

Learn why Health Alliance Plan relies on the MedInsight Hospital Evaluation and Comparison System (HECS) tool for hospital contracting.

BLOG

Milliman Healthcare Analytics Blog

We dig deep into rich Milliman MedInsight data to bring you insights you won’t find anywhere else, plus updates on the state of regulatory affairs.

Issue Brief

Identifying high-cost members

Do you know which members are likely to drive costs in the coming years? Learn how you can find out—before it’s too late to do anything about it.

We’re here to help

Ask the tough questions. We’re ready for them.