I was just relocating to India when Milliman began setting up operations there and I saw an ad in the newspaper. I was in the right place at the right time. I’d started as an occupational therapist, working in the U.K. with the National Health Service for about 12 years. Milliman was looking for expanding medical management consulting and I was looking for something that offered me more of a challenge and wider exposure to other markets and other projects.
I lead the clinical team. We are a small group of nine healthcare professionals: three doctors, three dental surgeons, a nurse, an occupational therapist, and a biomed engineer. We have experience from India, the U.K., the U.S., and Eastern Europe on the team, as well as some developing country experience.
Collectively, it's a very bubbly team. Many of us have been together since the start of Milliman in India. We’re considered a rather noisy team, because we often work in small teams on different projects. There are a lot of debates, arguments, and consensus generation—it’s wonderful. We challenge each other and complement each other.
We’re always kept on our toes because we need to use our clinical knowledge to create business solutions. We work on IT solution development, data analytics, and SQL skills, none of which are covered in traditional medical training. So we work closely with both the actuarial and the IT teams. We have learned to speak the mathematical expressions and technical logic vocabulary to the different team members. We learn and develop each day and feel great pride in our achievements over the past years.
One of the advantages of our Milliman India team is that we work together so well. When you're doing an actuarial assignment, whether it's pricing or benchmarking or data analytics, you need some clinical contextual understanding as well. It's not all in the data. For IT solutions, it is important to bring together the domain knowledge and workflow understanding. We have to foster clients identifying their needs for tomorrow and not just for today as we develop custom solutions. Our ability to combine IT, actuarial, and clinical skills under one roof is rare and gives us a competitive edge over our competitors.
We work on microinsurance programs, offering protection to the most vulnerable populations. It requires clinicians who can relate to the local needs. You cannot use a U.S.-based or a U.K.-based system to work in a developing country because the disease patterns would be very different, the cost patterns are very different, and the practices are very different as well.
In 2008, India started a program called Rashtriya Swasthya Bima Yojana, a state-sponsored social insurance scheme focusing on people below the poverty line, which has been very successful. The Indian state of Meghalaya wanted to make a more universal health insurance program. We helped them by looking at the disease burden of the state and costing the bundled rates for payment of different surgical procedures under the scheme. It’s critical that bundled rates reflect provider expenses or else the beneficiaries will be denied services or very high rates will challenge the financial sustainability of the scheme.
Various microinsurance schemes in India cover over 300 million people, and some large schemes cover nearly 100 million. Milliman's global experience has a lot to offer to these initiatives. We can help them achieve sustainability because we have an understanding of best practices and we have experience with different markets and different phases of development.
Milliman is known for creating unique, innovative solutions for its clients, and MedInsight® is part of the data warehousing solution. Last year, we started developing the MedInsight Waste Calculator. Everybody talks about waste in medical systems: unwarranted practices in hospitals which are costing money but do not have clinical benefit. Our waste calculator is incredibly valuable as it helps our clients profile the potential wasteful practices in their system and thereby promote quality outcomes and related practices.
My staff and I have been involved in other projects as well in India, Africa, and Europe. It's inspiring, it's challenging, it’s stimulating. After working on IT systems all day long with wonderful coding systems, you step into a hospital where all they have is a paper register. So how are you going to collect that information? It challenges you and makes you think wider and deeper into what is the priority here. It's a wonderful learning experience and it makes you stronger.