Milliman Advanced Risk Adjustment (MARA) software tops the competition in risk scoring study
Milliman, Inc., a premier global consulting and actuarial firm, today announced that its popular Milliman Advanced Risk Adjusters (MARA) software topped the competition in the latest study by the Society of Actuaries, “Accuracy of Claims-Based Risk Scoring Models.” Milliman achieved the highest overall performance among concurrent models, beating out eleven other vendors. MARA’s prospective models scored similarly well, ranking at or near the top in all four primary metrics measured.

Federal health exchange risk adjustment model now available in Milliman Advanced Risk Technologies’ MARA software
Milliman, Inc., a premier global consulting and actuarial firm, today announced that it has expanded its Milliman Advanced Risk Adjusters (MARA) software to include greater flexibility for calculating risk scores in and outside of health exchanges. The latest release includes the federal risk adjustment model developed by the U.S. Department of Health and Human Services (HHS) for use in the individual and small group marketplaces starting in 2014. The complex HHS-HCC model set, which employs the hierarchical condition category (HCC) grouping logic, requires specific diagnosis and demographic handling to calculate risk scores.


Rising risk: Maximizing the odds for care management
This analysis examines predictive models to determine if an enhanced model can better identify individuals with rising risk relative to traditional prospective risk adjustment models. It also evaluates the ability of these models to select members when costs increase in the future year.

Risk adjustment and shared savings agreements
The role of risk adjustment in shared savings agreements has been overlooked. There are numerous uncertainties involved in its potential impact, and there are steps to take to maximize its performance. By taking these steps, providers and payors can become more confident in the process, optimizing participation and motivation for all involved.

Catching up with Hans Leida
Hans Leida talks about innovation in predictive modeling, particularly in the area of risk adjustment models. This article was first published in the April 2015 issue of Predictive Modeling News.

When adverse selection isn’t: Which members are likely to be profitable (or not) in markets regulated by the ACA
The nuances and interactions inherent in the 3Rs can generate impacts that turn traditional risk management practices upside down.

Risk corridors under the ACA
We dispel some common misconceptions and demonstrate some of the less obvious aspects of the risk corridor program under the ACA.

Risk adjustment and the power of four
Separating the risk by service category for renewal underwriting significantly improves profitability.


ACA Risk Adjustment: Performance measures, potential bias, and strategy
Hans Leida moderates a presentation on ACA risk adjustment at a Society of Actuaries meeting.

Download audio (Society of Actuaries membership or purchase required)