Health Solutions
Providers
Reducing costs, improving outcomes
Increasing costs and complexity—along with new reimbursement models and changing treatment protocols—are putting a strain on providers. With our rich data, innovative technology, and unmatched domain expertise, we can help you improve patient health and care experience while optimizing efficiency.
Milliman provider solutions
Alternative payment models
Outcome- and risk-based payment models are a reality in today’s healthcare market. We have been working with alternatives to fee-for-service reimbursement since their earliest inception and can help you make these approaches not just a reality, but a success.
Medicaid and Medicare consulting
Regulatory complexity and cost control requirements make Medicaid and Medicare a tricky business for provider organizations. Milliman’s broad perspective and vast data resources help you maximize efficiency while raising the bar for care quality.
Operational consulting
Our operational consultants specialize in people, process, and technology to help you manage alternative payment models, staffing, predictive care analytics, regulatory compliance, accreditation, and waste reduction. We help you discover new levels of efficiency so you can focus on better care.
Stop loss insurance
In the shift from fee-for-service reimbursements to value-based contracts, insurance risk is passed to providers. Milliman can advise your company on stop loss coverage to mitigate risk in today’s risk-sharing payment models.
Feasibility analyses
Milliman helps providers in assessing their ability to take on varying amounts of risk.
Milliman providers products
Milliman Commercial Reimbursement Benchmarks
Access detailed, market-based provider commercial reimbursement benchmarks in multiple views, including Medicare FFS rates and allowed per RVU conversion factor.
Medicare Reference Pricer
Milliman’s integrated, customizable software solution for pricing claims based on Medicare allowable fees.
MedInsight
Adopt the healthcare industry’s leading platform for data warehousing and healthcare analytics.
Health Cost Guidelines Suite
Estimate expected claims costs and model healthcare utilization with Milliman’s Health Cost Guidelines™, an industry gold standard.
Milliman Advanced Risk Adjusters
Manage Medicare, Medicaid, and commercial risk adjustment with our award-winning suite of tools and data.
Hospital Performance Index
Analyze performance against national and regional best practices for strategic deployment of care management resources.
Bundled Payment Reporting Interface
Manage episodes of care under Medicare bundled payment models using the same logic and claims data employed by CMS.
Milliman MACVAT (Medicare Advantage Competitive Value Added Tool)
Evaluate relative values of Medicare Advantage program plans using a comprehensive, Excel-based tool.
Milliman ACO Builder
Leverage complete data, meaningful analytics, and Millman’s ACO expertise to analyze provider performance.
Dashboard for Research, Insight, and Validation of Experience (DRIVE)
Analyze historical data to inform policy decisions, validate encounter data, understand emerging experience, and more.
GlobalRVUs
Analyze healthcare relative value units (RVUs) across all healthcare services and provider types, using any data set.
HECS & RBRVS for Hospitals
Compare and benchmark hospital contracts on a patient-severity adjusted basis.
Milliman Price Transparency Solutions for Payers and Providers
Demystify payer and provider contract pricing data for better transparency across the industry.