Health Consulting Services

Stay current with complex regulations such as Solvency II and IFRS 17 with Milliman’s industry-leading expertise. We consistently refine our methodologies and models to align with market experience and regulatory requirements.

Supervisory topics

Stay informed about European and local supervisory matters and respond effectively. For example, the European Commission approved the negotiating mandate for the Insurance Recovery and Resolution Directive (IRRD) in 2022. Most European insurers will need a pre-emptive recovery plan by the end of 2024.

Solvency II 2020 review

We track the latest Solvency II 2020 review developments and provide updates through our Insight channel.

DNB supervisory topics

Milliman supports you in monitoring and addressing De Nederlandsche Bank (DNB) supervisory topics. We analyse HRES (Health Risk Equalisation System) factors by the Solvency II framework as input for discussions with DNB. We have helped clients respond to questions about climate, pandemic, and health underwriting risk.

DNB’s 2023 focus areas include interest rates, inflation, sustainability, cyber resilience, and risk margins. Additionally, DNB will consider the impact of the Future Pensions Act on insurers.

Milliman offers extensive experience in addressing the three pillars of Solvency II. We have particular strengths in the modeling complexities of Pillar I and the multiyear capital and balance sheet projections required for Pillar II ORSA.

Additional services related to Solvency II include:

• Methodology development and implementation
• Internal Model development and validation
• Internal Model Application Process (IMAP)
• Undertaking-specific parameter (USP) Application Process
• Health Risk Equalisation System (HRES) parameter recalibration shadow calculations (ONLY FOR NL website)
• Data quality
• Appropriateness analyses
• Actuarial Function Holder roles
• Risk Management Function roles
• Model validation
• Reporting and analysis streamlining
• Quarterly Reporting Templates (QRTs)

Read some of our articles:

• Analysis of insurers’ SFCR: European health insurers 2019
• Analysis of insurers’ SFCR: European health insurers 2018

Risk equalisation can protect consumers and stabilize healthcare and insurance markets where risk rating is not allowed.

Improving risk equalisation model

Our team has performed various projects for the Dutch Ministry of Health, Welfare, and Sport to improve the risk equalisation model for health insurers using Dutch healthcare consumption data and socio-economic factors.

Development of health risk equalisation systems

Building on our deep knowledge from the Netherlands and the world, we help governments create effective risk equalisation systems tailored to local and national needs.

Read some of our articles:

• Impact of COVID-19 on risk equalisation schemes
• How to equalise risk in healthcare systems

Reinsurance support

We support reinsurers in analysing the risk and profitability of covering Dutch health insurers and considering the effects of risk equalisation.

Sophisticated modeling tools and regulatory expertise enable accurate financial projections and reporting. Milliman valuation and projection tools assess how changes affect reserves and capital, delivering high-quality forecasts to support strategic decision-making. We are equally capable with proprietary and open-source solutions, with the independence to ensure objective selection.

Milliman’s experience spans open-source software and various market-available solutions. Our independence from specific software solutions allows us to effectively support you in software selection and implementation processes.

Setting up a capital projection model

We developed and implemented a balance-sheet-management framework and capital projection tool for one of the largest health insurers in the Netherlands.

Asset Liability Management support

We supported health- and medical-liability insurers in developing and implementing asset-liability models and policies aligned with their specific goals.

Solvency II mandates insurers appoint an Actuarial Function and a Risk Management Function. Overcome resource constraints and conflicts of interest by handing these functions to an independent Milliman consultant on a collaborative or fully outsourced basis.

Our leading analytics solutions enhance decision-making, measure and manage risk, increase predictive accuracy, and automate complex tasks.

Health insurance fraud detection: stop false claims before you incur costs

Combat fraud with sophisticated yet easy-to-implement models that only requires billing invoices for input. View anomalies through an easy-to-understand dashboard, enabling early action.

Read more:

• Anomaly detection techniques in fraud detection, performance optimization, and data quality
• Anomaly analysis and detection in health insurance

Explainable fraud detection: Understand your fraud detection models

When it comes to modeling and AI, transparency builds trust. We can demonstrate why specific data was flagged using explainable AI techniques and meta-learning models.

Read some of our articles:

• Explainable AI in fraud detection
• Evaluating supervised machine learning classification models in healthcare analytics
• Explainable AI in practice: Build trust and encourage adoption

Healthcare cost control and risk equalisation

In-depth knowledge of the Netherlands’ healthcare and risk equalisation systems enables us to support you in areas such as the following.

• Quantifying cost control incentives
• Analysing the impact of medical adherence on costs and risk equalisation
• Analysing risk-equalisation results and healthcare cost estimates
• Developing interactive web-based dashboards

Analytical support for healthcare procurement

Our machine-learning models forecast costs at the individual level, enabling accurate prediction of healthcare costs and as an alternative to actuarial and care-procurement models.

Read more:

• Machine learning in healthcare

Customer service analytics & automation

Enhance customer service with advanced consulting capabilities such as:

• Intelligent message distribution using email classification systems
• Extracting relevant information from unstructured data, such as text input
• Analysing customer-service calls using speech-to-text technology and natural-language processing
• Building chatbots to deliver seamless customer experiences

Milliman consultants can support you in all of these areas.

We help healthcare providers optimize patient care and financial outcomes with tools to enhance decision-making, measure and manage risk, increase predictive accuracy, and automate tasks.

Caregiver allocation: Long-term care predictive models

Allocate resources efficiently in the face of rapidly aging populations and limited caregiver resources using data engineering and predictive analytics techniques.

Customer service analytics & automation: Chatbots

Enhance customer service and reduce the strain on contact centres with intelligent chatbots.

Predictive analytics for care management: prevent costs

Improve cost efficiency by identifying and addressing undertreatment, overutilization, and patients likely to face rising costs.

Performance measurement and monitoring tools

Measure and monitor performance for primary and chronic care scenarios to drive improvement over time.

Meet litigation challenges with high-quality expert testimony and the evaluation of settlement alternatives. Our Benelux team has testified on loss quantification, risk equalisation contributions, and other highly technical topics.

We participate in virtually every insurance M&A in Benelux, bringing you unparalleled expertise on pricing, transaction potential, advanced modeling, and post-deal capabilities. Our consultants provide flexible support for buyers and sellers, with real-world experience in the complexities of M&A projects and the actuarial and financial risk guidance that drives success.

Seller Support

During the preparatory phase, we assist you with preparing information memoranda, valuing existing and new business, adjusting portfolios and models, and making strategic presentation decisions. In the M&A phase, we contribute to discussions with potential buyers and provide support during technical sessions.

Buyer Support

During due diligence, we identify opportunities and risks, perform in-depth analysis, lead expert sessions, and present results to inform decision-making. As part of post-deal integration, we support regulatory communication, entanglement process support, insurance portfolio integration, and the development of valuation and capital models.

Acquisition

After the contract is signed, Milliman aids in regulatory communication, securing formal sale approval, and completing the seller’s entanglement process. We help buyers integrate acquired portfolios or insurance entities, focusing on policies, claims, valuation, and capital models. Our experience in capital model integration helps ensure a successful acquisition and seamless incorporation into your risk management and reporting framework.

Take advantage of cutting-edge technology, rapid-response solutions, and efficient risk management approaches to combat rising cybercrime. We also help clients develop cyber-risk insurance products.

The health insurance sector has the potential to help society navigate emerging climate risks. We can work with you to identify and mitigate environmental, social, and governance (ESG) risks to your portfolio, anticipate future change, and incorporate sustainability topics in the ORSA and other reports.

Milliman Benelux Insurance & Financial Risk Consulting assists in selecting and implementing modern technology. Our independence from specific tools and other Milliman practices ensures unbiased support.

To learn more about software solutions developed by Milliman, visit the product page, or contact us.