Gorman Health Group Blog | We are implementing health reform

CMS Notice of Intent to Apply

October 5, 2017 | Regan Pennypacker

The Centers for Medicare & Medicaid Services (CMS) Annual Call Letter calendar marks November 13, 2017, as the first due date for the Notice of Intent to Apply. It is expected the Center for Medicare will release a reminder memo this month outlining the details. In general, the agency requires a Notice of Intent to Apply to be submitted when an organization plans on submitting a request for any of the following: Read more

2018 Medicare Advantage and Part D Show Strength, Value, and Emerging Trends

October 4, 2017 | John Gorman

The 2018 “landscape files” for Medicare Advantage (MA) and Medicare Part D from The Centers for Medicare & Medicaid Services (CMS) are out, and they show the two programs as stronger than ever, and providing great value to beneficiaries. A closer look at the numbers also reveals the strategies of market leaders to get in front of two seismic events in government health programs.

How to Make Your Next MA-PD Plan Implementation a Success

September 28, 2017 | Julie Billman

Friends of mine built a house. They indicated it was the most stressful event, full of decisions they didn’t know they needed to make, and struggled to agree. The timeline they hoped for was not reality and had to be reworked. While they said they were stronger having gone through the process and they love their house now, it wasn’t the fun event they thought it would be, and they never want to build a house again.

Another Battle Against TrumpCare Won, But the War Rages On

September 27, 2017 | John Gorman

Supporters of the Affordable Care Act (ACA) won another huge battle against TrumpCare this week, but the war rages on. The threat will continue to loom until Trump is removed from office, Democrats retake the House or Senate, or the Senate provides him a win with a bipartisan market stabilization bill in the wake of the stinging defeat of Graham-Cassidy, his third failure to repeal the ACA.

Now Is The Time To Start Planning For 2019 Medicare Advantage Growth

September 27, 2017 | Diane Hollie

Here are three planning questions you need to ask yourself right now:

Are you losing market share because you are not offering the right products or product mix?
How could the profitability of your Medicare Advantage (MA) enrollment change if you expanded your service area?
Is now the time to begin offering an MA plan?

Influencing Your 2019 Star Ratings: Every Day Matters

September 21, 2017 | Melissa Smith

With last week’s release by the Centers for Medicare & Medicaid Services (CMS) of draft 2018 Star Ratings to health plans, the now-annual “4^th quarter Star Ratings fire drill” has officially begun. Whether you dropped below the 4-star threshold required to earn quality bonus payments, or you hit 4 stars and are hoping to sustain it, the next six to eight weeks are critical to your success. But with only about 90 days remaining to connect members with the care they need for your success, every day and every decision matters.

Congressional Inaction Puts Government Health Programs in Jeopardy

September 20, 2017 | Olga Walther

The packed agenda for Congress promised us a whirlwind of a month, and it certainly came with its share of surprises. Despite the appearance of progress, however, we still don’t have answers to any of the pressing healthcare legislation questions as we conclude our third week of September. With one week remaining, action looks pretty grim for many of the government health programs, including the Children’s Health Insurance Program (CHIP) and the Affordable Care Act (ACA), mainly due to the sudden resurgence of ACA repeal talks.

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