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