Chief utive Officer
Assistant Managing Director
Milliman is among the world’s largest independent actuarial and consulting firms. Founded in 1947, it operates in more than 15 countries and has more than 50 offices worldwide. Milliman’s practice in India was started in 2005 and combines unparalleled clinical, actuarial, and IT expertise with a global perspective to develop solutions and innovative products for the Indian healthcare, insurance, and allied markets.
The Milliman clinical team offers a wide range of services and products, including clinical protocols, health risk assessment tools, claims processing, and underwriting guidelines. These applications, which use evidence-based clinical content, are rapidly emerging as the gold standards in the Indian healthcare and health insurance industry.
The actuarial team provides health insurance product designing and pricing services, data analysis services, IBNR and reserving studies, and market entry advice. It services clients in India and markets as diverse as Hong Kong, the United Kingdom, and the United States. Milliman’s IT team in India develops solutions for data warehousing, analytics, and performance reporting. It also develops specialised tools and applications that leverage Milliman’s leading actuarial and clinical methodologies.
- Clinical Protocols and Pathways: Clinical protocols are evidence based recommendations which guide the clinical team to take clinical decisions at various stages. Clinical pathways are medical documentation tools which list critical criteria to help physicians order appropriate investigations and interventions in a logical sequence of patient care needs. Presently developed for 70 conditions covering 15 specialities.
Health Risk Assessment (HRA) Tool: This tool collects a wide range of information including health status, lifestyle behaviors, family history, work environment, resident environment, physical activity and transport, etc. to identify risks that could affect the current and future health and wellness of a respondent. The HRA, developed for corporate clients and insurance companies, provides a structured mechanism to create a lifestyle and wellness self-management tool that provides customised and actionable recommendations to respondents. The web based tool is based on published research and customisable for specific business objectives.
ClaimsRef (Claims Processing Guidelines): Clinical reference criteria to assist insurance companies and TPAs process health insurance claims. Presently cover 200 common in-patient medical and surgical interventions. They are available as a web look up and clinical logic that can be integrated into a claims management platform.
Indian Medical Underwriting Recommendations: These comprise of evidence supported clinical summaries as guidance for the underwriter on actions to be taken in case the proposal form or the medical checkup reveals past history or existence of a medical condition.
- Milliman Health Cost Guidelines: A comprehensive rating tool for health insurers. These include utilisation rates for specific services, claim probability distributions, variations in costs in different parts of the country -critical data that can be used by health insurers for product pricing and benchmarking. Health Cost Guidelines are regarded as gold standard in the US and are replicated in various other markets such as Hong Kong and UK. HCGs are currently being developed for Indian market.