Health Policy Analysis
No shortage of ink gets spilled Washington guessing what a particular President, Congress or CMS administrator will "do to" the Medicare program. But more often than not, the real drivers of change are found well below the headlines.
Unlike many other policy shops, Gorman Health Group pays close attention to the business implications of proposed shifts in policy. This allows us to model scenarios based on possible outcomes of Legislative, regulatory, and sub-regulatory guidance. Our intimate knowledge of operations allows us to see into the future -- while many analysts praised the growth of PFFS, and policy wonks predicted its demise, we saw a more basic issue at play: it's darn hard to pay claims even when you have a contract with a provider. And when you don't? Well, let's just say that the high MLR's of some plans in the immediate following years didn't surprise GHG clients.
Our policy team is made up of former regulators who literally “wrote the book” on Medicare program regulations. This perspective allows us to focus on what changes are likely and which are most meaningful: two simple things that are often lost in political grandstanding. And because so much of the meaningful change happens in sub-regulatory guidance, the operational perspective of our firm provides a sophistication not found elsewhere.
Our consultants will help you cut through the speculative clutter to find real insights for your business.
