Medicare consulting services — Strategy & general support


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Medicare product positioning

Milliman consultants analyze your organizational strengths, your target populations, competitors, operational and compliance challenges, and the related financial implications to guide your organization toward sound business decisions. Our advice spans situations where organizations are considering entering new markets, adjusting product portfolios in current markets, and/or exiting markets.

Long-term planning & Reform analysis

Milliman consultants help clients understand Medicare reform by estimating program change impacts, evaluating potential mergers, developing exit strategies, and analyzing long-term population aging trends.

Financial reporting support

Milliman consultants estimate reserves, analyze revenue and claim experience, project financial results, and perform other financial analyses for Medicare products. Our analyses appropriately reflect the seasonality, risk adjustment, risk-sharing/refund, and durational issues unique to Medicare products.

Mergers & Acquisitions

Milliman consultants guide clients through the complexities of buying or selling, whether a proposed transaction involves a single line of business or an entire company. We have unique experience working on many facets of mergers and acquisitions related to medical expense, disability, long-term care and other forms of health insurance.

Using Milliman's extensive network of contacts, our consultants have helped connect sellers and buyers and give valuable strategic advice in the initial stages of a merger or acquisition. We also assist either party in estimating a likely range of prices for a proposed transaction and perform in-depth technical actuarial modeling as part of the due diligence process.

Milliman provides highly detailed due diligence reviews to refine the process. We use mathematical and technical actuarial skills to allow buyers to validate the assumptions used to price a prospective acquisition and explore issues such as data integrity, valuation procedures, administrative processes, reinsurance agreements, and contract language. Our clients know we bring decades of experience to examining businesses in detail and they rely on our findings and recommendations.

Medicare-specific business intelligence system

The MedInsight business intelligence system, jointly developed by our actuarial and healthcare technology consultants, presents organizations with information that allows them to better understand and monitor their Medicare business. MedInsight includes cost and utilization benchmarks, trend, risk scores, and prospective high-cost member analyses.

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