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HEALTH SOLUTIONS

Medicare

Making Medicare work for all concerned

OVERVIEW

Milliman Medicare solutions

Medicare Advantage

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Medicare Part D

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Operational consulting

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Bid development, desk review, and audit support

Bid development, desk review, and audit support

Webinar series

All things Medicare

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Insight

Milliman Medicare insight

White paper

Milliman MedIntel Part D trend insights

Utilization trends for non-low income Part D members show no signs of slowing in the first half of 2025

Report

2025 Milliman Retiree Health Cost Index

Retirement planning: How much money will you need to cover your healthcare expenses?

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White paper

The 2024 ACPT update: A modest improvement in shared savings

With a change by CMS in the accountable care prospective trend in the Medicare Shared Savings Program, ACOs could leave potential savings on the table.

White paper

Commercial reimbursement benchmarking 2025

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

White paper

Understanding prospective vs. retrospective assignment in MSSP: Examining the assignment methodology for 2024 and beyond

Under the Pathways to Success rule, ACOs in the Medicare Shared Savings Program must carefully evaluate whether to use prospective or retrospective assignment.

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INTERACTIVE REPORT

Milliman Qualified Entity Report

Explore healthcare system performance as it relates to social determinants of health.

White paper

Emerging Medicare Advantage and Part D trends from 2024 financial statements

Medicare Advantage (MA) and Part D insurers are citing significant financial headwinds in earnings calls and the press. Statutory financial statements provide insights into emerging trends through year-end 2024.

White paper

The federal Medicaid matching rate: The changing landscape from the state perspective

In this article, we provide an overview of current financing for Medicaid and the Children’s Health Insurance Program (CHIP).

White paper

Key insights into 2025 Medicare Advantage D-SNP landscape

D-SNP market experiencing slower growth amid broader Medicare Advantage market and regulatory changes.

White paper

2025 MA industry: General enrollment plan valuation and selected benefit offerings

In our review of the state of the 2025 Medicare Advantage industry, we highlight changes in value-added and key benefit trends.

landmark legislation

Healthcare changes in the Inflation Reduction Act

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RELATED PRODUCTS

Milliman Medicare products

Benchmarking
HEALTHCARE UNIT COST INSIGHTS

Milliman Commercial Reimbursement Benchmarks

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Claims data analytics
Claim pricing

Medicare Reference Pricer

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Medicare advantage benchmarking
Medicare Advantage benchmarking

Milliman MACVAT (Medicare Advantage Competitive Value Added Tool)

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Healthcare cost modeling
Healthcare cost modeling

Health Cost Guidelines Suite

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Healthcare analytics
Healthcare analytics

MedInsight

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Claims data analytics
Claims data analytics

Medicare Repricer

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Healthcare analytics
ACO analytics

Milliman ACO Builder

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ACA utilization and cost evaluation
Medicare plan selection solution

Medicare Suggest

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Healthcare risk adjustment
Healthcare risk adjustment

Milliman Advanced Risk Adjusters

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Alternative payment
Alternative payment

ACO Care Management Impact Model

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Claims data analytics
Claims data analytics

Bundled Payment Reporting Interface

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RELATED SERVICES

Milliman Medicare services

Resources

Milliman Medicare resources

Article

Medicare Advantage Uniformity Flexibility benefit offerings

A review of the Uniformity Flexibility benefits offered during the contract year 2019 plan year.

Video

Optimizing hospital partnerships

Learn why Health Alliance Plan relies on the MedInsight Hospital Evaluation and Comparison System (HECS) tool for hospital contracting.

BLOG

Milliman Healthcare Analytics Blog

We dig deep into rich Milliman MedInsight data to bring you insights you won’t find anywhere else, plus updates on the state of regulatory affairs.

Issue Brief

Identifying high-cost members

Do you know which members are likely to drive costs in the coming years? Learn how you can find out—before it’s too late to do anything about it.

We’re here to help