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Where wellbeing is the bottom line

OVERVIEW

Milliman health plans solutions

Advanced analytics

Advanced analytics

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Insight

Milliman health plans insight

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Report

Commercial health insurance: Detailed 2023 financial results and emerging 2024 and 2025 trends

This report provides a detailed analysis of insurer financial results for the U.S. commercial health insurance market, for both individual and group plans.

White paper

Commercial reimbursement benchmarking

Commercial payment rates for medical services as percentage of Medicare fee-for-service rates

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White paper

Beyond access and adequacy: Strategies for developing provider networks that meet patient needs

A patient’s entry point to receive the care they need is shaped by which providers are in their health insurer’s contracted network.

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Briefing note

Key considerations for Medicaid-focused insurers starting an ACA line of business in light of Medicaid eligibility redetermination

Between 8 million and 24 million people could potentially lose their Medicaid coverage during the 12-month Medicaid eligibility redetermination process....

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Article

At-home COVID-19 testing costs for commercial health plans

We estimate the financial impact of the federal requirement for employers and individual insurance plans to cover self-administered and self-read COVID-19 tests.

Article

Clinical and cost tradeoffs of surgery

We examined 15 medical conditions where surgery is an option and discovered a surprising percentage of potentially avoidable procedures. Learn about the cost and care impacts.

White paper

The changing landscape of out-of-network reimbursement

What are some best practices in setting out-of-network provider reimbursement levels? How can you achieve cost savings while avoiding unfavorable outcomes? Get answers here.

Video

How Monterey is reinventing healthcare

When confronted with rising costs and shrinking reimbursement, leaders at a hospital in California took a bold step to ensure that they could continue serving the needs of the community in a financially sustainable way.

Research Report

Milliman Medical Index

Read our latest analysis of healthcare costs in the U.S., including prescription drug and employer contribution trends.

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Video

The real cost of healthcare waste

See how we’re helping clients reduce costs and improve patient outcomes.

RELATED PRODUCTS

Milliman health plans products

Healthcare analytics

MedInsight

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Insurance risk assessment

IntelliScript

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Benefit plan evaluation

CORAL

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Healthcare cost modelling

Health Cost Guidelines Suite

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Medical underwriting

Milliman Medical Underwriting Suite

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Insurance risk assessment

Integrated Medical and Pharmacy Record Optimization and Validation Engine (IMPROVE)

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Claims processing and data analysis

Milliman Health ClaimsRef

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Healthcare cost modelling

Dashboard for Research, Insight, and Validation of Experience (DRIVE)

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Healthcare Risk Adjustment

EDGE ASSIST

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