Critical Point

Milliman, Inc.

Objectivity matters. Today, more than ever. With no agenda, other than getting it right, Milliman’s Critical Point podcast takes a deep dive into subject matter that affects the health and well-being of people across the globe, from healthcare to retirement security, flood insurance to autonomous vehicles. Through a team of professionals ranging from actuaries to clinicians, technology specialists to economists, Critical Point examines the inherent challenges – and innovative solutions – that Milliman consultants encounter through their daily work around healthcare, employee benefits, risk management, technology, investment consulting, insurance, and financial services.

  • 35 minutes 45 seconds
    How have healthcare costs changed since 2005?

    Since 2005, the Milliman Medical Index (MMI) has estimated annual healthcare costs for people covered by a typical employer-sponsored health plan. To mark the 20th anniversary of the report, MMI authors past and present gathered to review how healthcare has changed over the past two decades. They discussed the impact of the Affordable Care Act and the COVID-19 pandemic, the rise in drug advertising and outpatient care, and how trends might change again in the next 20 years.

    You can read the episode transcript on our website.

    18 September 2025, 9:00 pm
  • 27 minutes 53 seconds
    Cash balance plans: Why small businesses and professional services firms are adding this retirement benefit.

    While the number of traditional pensions has been shrinking for decades, one type of defined benefit (DB) plan is expanding: the cash balance plan. Combining features of DB and 401(k) plans, cash balance plans are particularly well-suited to helping small-business owners and highly paid professionals such as doctors and lawyers save for retirement. On this episode of Critical Point, three Milliman employee benefits experts explain why the number of cash balance plans has recently swelled to 25,000, how plans can be tailored to fit organizations of all sizes, and why this hybrid plan style may help address the looming retirement crisis. 

    30 June 2025, 8:00 pm
  • 16 minutes 50 seconds
    The cost of extreme weather in Europe

    In Europe, flooding was the most prevalent—and most expensive—climate peril last year, making 2024 the “Year of the Flood.” On this episode of Critical Point, five authors of Milliman’s annual Extreme Weather in Europe report assess the toll of flooding in their country and the response from insurers, governing bodies, and communities. They discuss what Italy is doing to protect the insurance industry, how construction in the UK and France may be contributing to flood risk, and why new regulations in Romania and the Benelux region may not do enough to keep pace with climate change. 

    Don’t miss the full Extreme Weather in Europe report, as well as the related paper, Flood risk modelling in Europe, both available at Milliman.com.  

    3 June 2025, 3:00 pm
  • 28 minutes 44 seconds
    Artificial intelligence and insurance, part 3: Global regulations and trends

    AI has taken the world by storm—but not all insurance companies, or countries, are approaching the technology the same way. On this special episode of Critical Point, experts from Munich Re and Milliman who work across five continents come together for a global conversation exploring how insurers and regulators are approaching AI around the world. Plus, don’t miss Part 1 and Part 2 of this series on AI and insurance. 

    You can read the episode transcript on our website.

    11 February 2025, 4:00 pm
  • 25 minutes 57 seconds
    How can Medicaid pay for cell and gene therapies?

    Cell and gene therapies have been grabbing news headlines, both for their potential to cure rare diseases and for their million-dollar price tags. Milliman pharmacists and healthcare experts explain why state Medicaid agencies are particularly affected and the strategies many are using for predicting uptake and covering these high costs. 

    You can read the episode transcript on our website

    17 December 2024, 2:00 pm
  • 20 minutes 28 seconds
    Healthcare costs in a presidential election year

    Healthcare costs are a hot topic as we approach open enrollment and the presidential election. In this episode of Critical Point, host Deana Bell sits down with Dave Liner and Jason Clarkson, principals at Milliman and co-authors of the Milliman Medical Index (MMI), to discuss the key drivers of 2024’s healthcare costs. They dive into the effects of government programs like Medicaid and the Inflation Reduction Act, the rising use of weight loss medications, and how these factors are shaping healthcare costs for Americans on employer-sponsored insurance. Learn how policy changes and market trends could impact your healthcare expenses and decisions in the coming year.

    You can read the episode transcript on our website.

    7 October 2024, 4:00 pm
  • 22 minutes 59 seconds
    Ten questions everyone’s asking about captives

    Cyber risk, climate change, new pharmaceutical therapies—as companies look for ways to manage increasing costs and unforeseen exposures, captives are a popular mechanism to insure against the unexpected. Around since the 1950s, today there are more than 7,000 captive insurers worldwide, with many headquartered in Vermont, Bermuda, and the Cayman Islands. As these insurance vehicles grow in popularity, Milliman experts answer the top 10 questions everyone’s asking about captives.

    You can read the episode transcript on our website.

    12 August 2024, 6:00 pm
  • 28 minutes 43 seconds
    Increasing diversity in clinical trials

    Drugmakers are taking steps to make sure clinical trials include participants from a variety of backgrounds—and they are steadily making progress, as evidenced by new studies of multiple sclerosis and sickle cell disease. Milliman health researchers Ellyn Russo and Chris Page unpack a history of distrust in medical research, the implications of failing to attract diverse study participants, and how simple strategies like rideshare vouchers, childcare, and check-in apps can help expand a study’s reach, so more patients have access to the latest treatments and medical research moves forward.

    You can read the episode transcript on our website.

    27 June 2024, 3:00 pm
  • 29 minutes 9 seconds
    Why life insurers are investing in private equity and real estate

    Life insurers have historically invested their portfolios in the relative safety of mortgages and bonds, but economic volatility, sticky inflation, and other headwinds have spurred many insurance companies to diversify into alternatives, a trend explored in a recent Milliman paper. On this episode of Critical Point, three of the paper’s authors discuss two alternative asset classes that are particularly attractive to insurers in today’s market: private equity and real estate. They talk about unexpected assets like student housing and storage facilities, the synergy of private equity firms investing in insurers and vice versa, and why many insurance companies continue to hold commercial real estate despite post-pandemic office vacancies.

    You can read the episode transcript on our website.

    16 May 2024, 4:00 pm
  • 19 minutes 57 seconds
    Are corporate pension plans making a comeback?

    For decades, companies with traditional pensions have been freezing those plans and replacing them with defined contribution options to help their employees save for retirement. But IBM made headlines when it restored its defined benefit program in early 2024. Three Milliman pension actuaries discuss this choice, new hybrid DB plan designs, and how plan sponsors can avoid the mistakes that led them to close their pension plans in the first place.
    You can read the episode transcript on our website.

    11 March 2024, 5:00 pm
  • 41 minutes 18 seconds
    Growing the actuarial profession in the developing world: Where the UNDP-GAIN initiative stands after one year

    Actuaries are vital to the insurance industry and national economies, but the profession is still emerging in many developing countries. That’s why Milliman and the United Nations Development Programme have launched a program to increase actuarial capacity around the world. In this episode, five Milliman volunteers reflect on the initiative’s first year and their work in 10 countries, from Nigeria to Nepal.

    You can read the episode transcript on our website.

    5 December 2023, 11:00 pm
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