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Objectivity matters. Today, more than ever.

Independent for over 70 years, Milliman delivers market-leading services and solutions to clients worldwide. With no agenda, other than getting it right.

Through a team of professionals ranging from actuaries to clinicians, technology specialists to plan administrators, we offer unparalleled expertise in employee benefits, investment consulting, healthcare, life insurance and financial services, and property and casualty insurance.

News

  • 19 February 2019 — Captive Review
    The 2018 Captive Review Power 50
  • 14 September 2018 — Wall Street Journal
    Florence flood threat heightened by underinsured homeowners
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Long-term care consulting

We offer unmatched depth and breadth of knowledge in long-term care.

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Expanding access to quality healthcare for a California community.

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Helping clients understand and navigate retirement risk

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Recent stories

  • Amendments to IFRS 17 from February 2019 IASB Meeting
  • An end to manufacturer rebates as we know them today?
  • Year-End 2018 Actuarial Function: What's new
  • Pathways to Success MSSP final rule: Winners and losers
Solvency II

Recalculation of the Transitional Measure on Technical Provisions

insightMilliman insight

All insightHealthcareEmployee Benefits and InvestmentInsuranceRisk Management and Financial Services
The essential eight: Keys to successful ACO contracting
The essential eight: Keys to successful ACO contracting
Roundtable: Private market ACOs
Next Generation ACO Model: Should we take the plunge?
Five common pitfalls in commercial ACO shared risk arrangements
Five common pitfalls in commercial ACO shared risk arrangements

Accountable Care Organizations

  • Why accurate claims coding for MSSP ACOs has become increasingly important

    By Jonah Broulette, Noah Champagne, Kathryn V. Fitch | 26 June 2018

    This brief explains how benchmark year 3 risk scores affect the benchmark calculation for Medicare Shared Savings Program (MSSP) renewals, presents an overview of the prior and new MSSP benchmark calculations, and illustrates how the change can affect an accountable care organization’s benchmark under various scenarios.

  • Considerations regarding the Next Generation ACO stop-loss methodology

    By Hugh Larson, Timothy J. Wilder, Annie Man, Coleen Young | 22 December 2017

    This report identifies several important considerations regarding the impact of the stop-loss provision on participating Next Generation accountable care organizations.

  • Individual stop-loss is now optional for Next Generation ACOs

    By Hugh Larson, Timothy J. Wilder, Annie Man, Coleen Young | 08 November 2017

    For some Next Generation Accountable Care Organizations, the choice between an annual financial reconciliation based upon capped claims or uncapped claims could have a significant impact.

  • Next Generation ACO Program financial results for 2016

    By Hugh Larson, Timothy J. Wilder, Annie Man, Coleen Young | 08 November 2017

    This paper describes the financial results of the Next Generation Accountable Care Organizations program.

  • What predictive analytics can tell us about key drivers of MSSP results

    By Jill S. Herbold, Anders Larson, Cory Gusland | 28 September 2017

    This article provides insight into the 2015 gross savings/(losses) achieved by accountable care organizations in their third performance year of the Medicare Shared Savings Program.

  • Telehealth under alternative payment models

    By Susan Philip | 13 September 2017

    Telehealth has the potential to boost the impact of population health management initiatives while improving access and convenience of healthcare delivery.

  • Regulatory capital strategies in an evolving health insurance landscape

    By David M. Liner | 30 August 2017

    As the relationship between health plans and healthcare providers continues to evolve, this landscape creates new financial opportunities for health plans managing regulatory capital.

  • Performance of skilled nursing facilities for the Medicare population

    By Anders Larson, Jill S. Herbold | 09 December 2016

    This report discusses a framework and metrics for measuring skilled nursing facility (SNF) performance, explores SNF performance levels across the United States, and provides a quantitative assessment of the opportunity to reduce spending for SNF services through steerage of patients to more cost-efficient SNFs.

  • Five common pitfalls in commercial ACO shared risk arrangements

    By Adam Laurin, Cory Gusland | 31 August 2016

    For shared risk agreements to be transformational, providers and payers must work together to construct agreements that adequately reward providers, are economically viable over a multiyear period, and strive to transfer care management risk.

  • Next Generation ACO Model: Should we take the plunge?

    By Charlie Mills, Cory Gusland, Noah Champagne | 31 March 2016

    This article identifies five key considerations that all accountable care organizations (ACOs) should closely review before deciding whether or not to use the Next Generation ACO Model.

See More Articles

  • 15 October 2015

    The essential eight: Keys to successful ACO contracting

    This article discusses common elements critical to analyzing and understanding shared risk and population-based arrangements.

  • 03 September 2015

    Benefits Perspectives: Introduction to shared savings arrangements and ACOs

    This Benefits Perspective provides an introduction to accountable care organizations and shared savings arrangements for employers that sponsor self-funded group health plans.

  • 19 March 2015

    Healthcare, provider reimbursement, and the changing financial terrain

    Healthcare providers should start thinking about strategies for defending and gaining market share sooner rather than later.

  • 11 March 2015

    Challenges with measuring savings in shared savings arrangements

    Shared savings arrangements have become a more popular way to incentivize providers to improve the efficiency and quality of healthcare.

  • 02 December 2014

    Back to the future: Provider risk-sharing: 1985 or 2015?

    Provider organizations and risk-taking arrangements may look like those from the past, but with new legislative initiatives, there is now a very different risk-taking environment.

  • 23 April 2014

    Health plan consumerism: Who is the consumer?

    Current consumerism focuses all attention on plan plan participants; the future of consumerism should expand to include physician-focused consumerism.

  • 13 February 2014

    Medicare ACO Shared Savings plans: Grading on a curve

    Bonus calculation methods in the Medicare Shared Savings Program should improve medical cost trends but may put pressure on ACOs.

  • 01 November 2012

    Perspectives on medical malpractice self-insurance financial reporting

    Perspectives on medical malpractice self-insurance financial reporting.

Affordable Care Act research

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  5. Healthcare reform reading list: From the ACA archives
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  10. Medicare ACOs and Alternative Payment Models
  11. Provider
  12. Employee Benefits and Investment
  13. Defined benefit plans
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  15. Investment
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  17. Analytics and modeling
  18. Catastrophe risk and insurance-linked securities
  19. Insurtech
  20. Life insurance
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  22. Medical professional liability
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  24. Risk management
  25. Solvency II
  26. Telematics
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  28. Enterprise risk management
  • Periodicals

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  • Featured videos

    • ACO Part2 - ThumbnailHealthcare costs and accountable care organizations(3:58)
    • Medicaid - ThumbnailUnderstanding healthcare costs: Medicaid(4:44)
    • Opportunities in Healthcare Reform - ThumbnailOpportunities in healthcare reform(1:51)
    See all video
  • Healthcare Town Hall

    • What must health insurers consider regarding IFRS 17?Feb 20, 2019
    • CMS proposal to include dementia to Part C risk adjuster may impact health servicesFeb 19, 2019
    • Expanded definition of primarily health-related benefits alters the Medicare Advantage marketplaceFeb 15, 2019
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About Milliman


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For more than seven decades, Milliman has combined technical expertise with business acumen to create elegant solutions for our clients. 

Today, we are helping companies take on some of the world's most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.


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