Medical management


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We combine our broad knowledge of global healthcare best practices with our understanding of local infrastructure, customs, and cultural issues to conduct effective medical management reviews in Central and Eastern Europe. Our experience encompasses concurrent reviews, post-discharge reviews, ambulatory case management reviews, disease management programmes, and claims management.

Milliman's local consultants understand the specific differences in the healthcare systems of countries throughout Central and Eastern Europe. We assemble multinational, multidisciplinary teams of actuaries, physicians, and other clinicians to perform robust operational reviews on-site at hospitals.

Our team interviews facility staff, mapping the staffing ratios, culture, processes, and skill mix of medical management personnel. We review this information with the organisation's data to discover the most fertile areas for possible improvement. Finally, we work to implement changes throughout the organisation so that improvements are not undermined by policies or practices in other departments.

Advanced tools for operational analysis

In our operational reviews, our experts employ Milliman's robust analytical tools to uncover inefficiency. Our in-house benchmarks grant healthcare organisations in developing markets access to best-practice knowledge from the most efficient markets in the world, pointing the way not only to cost savings but also to improvements in the quality and effectiveness of care.

An operational review leads to a successful merger

Milliman assisted a venture capital group in assessing the capabilities of a Bulgarian health insurer for a potential purchase. Our UK consulting team reviewed the insurer’s underwriting capabilities, claims control, actuarial functions and methods, data capture, provider network capability, and information technology systems, summarising our findings in a detailed report.

As a result of Milliman's work, the client was able to purchase the company with a deep understanding of its strengths and weaknesses. The acquirer also gained in-depth knowledge of the insurer's future potential for expansion.

Next Steps

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