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Commercial reimbursement benchmarking
Commercial payment rates for medical services as percentage of Medicare fee-for-service rates
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.
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....
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.
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.
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.
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.
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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The real cost of healthcare waste
See how we’re helping clients reduce costs and improve patient outcomes.