Population healthcare management

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Milliman assists accountable care organizations (ACOs) with effective population healthcare management, from setting goals and performance targets to achieving desired financial results. 

Payors are moving away from a fee-for-service model, demanding better management of costs and a reduction in healthcare utilization per patient. As providers reorganize as ACOs, they face greater scrutiny, having to meet cost-mitigation requirements while delivering enhanced care through more in-depth monitoring. 

We provide comprehensive population management services, from initial measurement and evaluation of efficiency, to setting up key tactics for improving performance and reducing costs. Our tools include a sophisticated data warehousing tool tailored for ACO needs, with performance reporting across claims, enrollment, and pharmaceutical records. This platform—MedInsight®—combines vital patient information into a single, comprehensive reporting system that can accurately generate performance metrics on demand. By making high-quality data easily accessible, MedInsight empowers evidence-based decision-making and strengthens care management.

Our in-depth approach for population healthcare management also includes: 

  • Cost optimization. Milliman analyzes monthly claims data from health plans to look for patterns of waste or medically unnecessary utilization, and identifies medical management tactics that can be implemented to address these opportunities. 
  • Negotiations. We help new ACOs evaluate risk contract terms with payors to mitigate risk and maximize savings.
  • Budgeting. We provide estimates for the population an ACO is receiving, in addition to conducting ongoing monitoring services to help an organization understand whether it is in line for quality incentives. 
  • Goal setting and benchmarking. We help organizations model a range of effective performance goals for every possible procedure and know whether the organization is meeting the parameters or is able to improve on them. Our database and data management gives an ACO important feedback on where it stands versus competitors. 
  • Patient acquisition. We work with organizations as they take on patient populations to help them deliver efficient care for these new or expanded patient groups. 

Get started

Contact us to learn how Milliman can help your ACO improve its efficiency in the management of its healthcare population and meet the challenging cost-mitigation demands of payors.

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