Operational review


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Milliman’s India healthcare practice brings together multidisciplinary teams and international expertise to conduct operational reviews and develop cost-effective solutions. Our consultants include actuaries, IT experts, physicians, and other clinical staff, bringing an unusual breadth of healthcare and domain knowledge to these tasks.

Our consultants conduct extensive on-site operational reviews, utilizing our healthcare domain knowledge and global experience, to help clients identify areas for further efficiency and offer specific recommendations. Our key process review includes underwriting and claims process reviews. We assist clients with identifying the most cost-effective programs offering the best financial and quality outcomes for a client's specific operating environment. We identify clients risk appetite to formulate operational review criteria and the linkages with other functions to position the performance monitoring systems.

We conduct on-site process shadowing, interview key staff, review documents and manuals to examine the culture, procedures, and staffing skill mix of an organization, and then analyze the client's data within that context. Our team then offers specific recommendations for improving work processes for efficiency and quality.

Adopting evidence-based medical tests

Milliman healthcare experts conducted a review of pre-policy medical tests for an Indian health insurer. The client wanted to identify the most appropriate tests for their retail health product in India.

Our clinical team conducted a rigorous evidence-based review and recommended the ideal combination of tests from a cost-effective and scientific-underwriting perspective.

Redesigning proposal form to enhance information capturing

A health insurance company in India requested Milliman to conduct a workflow process review for its underwriting department. Our domain and clinical experts developed a new proposal form and made recommendations to optimize the medical underwriting for the insurer. This included developing a decision-support matrix and the introduction of Integrated Voice Recording (IVR) technology as part of the tele-underwriting process.

Next steps