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Healthcare risk modeling

Milliman Advanced Risk Adjusters

At the heart of population health analytics

The challenge

Understanding health risk requires in-depth insight into complex medical and social factors

When your challenges include financial and care decisions, Milliman Advanced Risk Adjusters® (MARA) helps you face those challenges with confidence through better understanding of the needs and risks of your population.

The solution

Get ahead of risk with MARA, an industry-leading solution for population health analytics

MARA population health models and tools offer person-centric, clinically meaningful risk profiles. Discover risk by health service categories to:

  • Analyze acute, chronic, complex, and social drivers of clinical risk
  • Segment members by expected cost increase or decrease
  • Identify risk of emergency department visit or hospital admission
  • Evaluate social and community-specific health risk factors
MEDICAID MEDICALLY FRAIL DETERMINATION

Milliman Medicaid Frailty Solution

Milliman is uniquely qualified to assist states in implementing medically frail determinations for their Medicaid populations as required under HR1. Medically frail determinations need more than just a technological change order. The Milliman Medicaid Frailty Framework combines Milliman’s proven and industry leading software with actuarial, policy, and clinical consulting knowhow to provide a solution that goes beyond the ones and zeros to support states with financial modeling and policy analysis.

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Make financial decisions with confidence

For health plans, payers, and third-party administrators (TPAs)

Assess and compare risk among employers, providers, accountable care organizations (ACOs), and lines of business, while gaining insight to support budgeting, pricing, underwriting, risk adjustment, payment, and program measurement.

For providers and ACOs

Gain predictive insight for risk-sharing programs, value-based contracts, and performance measurement systems. Monitor concurrent risk over time to track changes in patient risk profiles, segment patients whose costs will increase and stay ahead during the performance period.

Rising Risk

MARA’s powerful Rising Risk models

MARA Rising Risk models differentiate, classify, and allow users to assemble cohorts of members by whether their cost will stay the same, decrease, or rise. MARA results offer greater precision for classifying populations, identifying risk drivers and enabling better decisions for care programs, staffing needs to achieve results, and measuring success.

BENEFITS

MARA Benefits

FEATURES

MARA features

PRODUCTS

Products related to MARA

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MedInsight

Adopt the healthcare industry’s leading platform for data warehousing and healthcare analytics.

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Healthcare cost modeling

Health Cost Guidelines Suite

Estimate expected claims costs and model healthcare utilization with Milliman’s Health Cost Guidelines™, an industry gold standard.

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Resources

MARA resources

Brochure

TPA Risk Intelligence

Two entry points. One unified risk story.

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White paper

Medically frail determinations under new Medicaid requirements: Experience-based insights

We offer some experience-based insights for medically frail determinations under the new Medicaid work requirements to help states implement an accurate, compliant solution.

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Report

Unlock superior population health insights: Measuring the predictive accuracy of MARA v5

We assess how well the latest XPLN models for MARA predict annual healthcare spending and the occurrence of acute medical events for people with insurance.

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BROCHURE

MARA v5 Library of Models

Includes models for Commercial, Medicaid, Medicare Advantage and MSSP populations.

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We’re here to help

Ask the tough questions. We’re ready for them.