from opportunity to operations
Guidance and support in every strategic and operational area in Government–sponsored health programs
For well over a decade, we have been the go-to firm for the managed care industry for all aspects of marketplace survey, product positioning and long range strategy.
We have brought scores of Medicare Advantage Plans, Prescription Drug Plans, Special Needs Plans and Exchange participants to market. We will work with you to understand your market, mining demographic data for opportunity and finding the gaps in the competitive field into which your plan can fit. And we will position you for the challenges — and opportunities — posed by health reform, designing a strategy that takes into account your service area, market environment, core competencies, and vision of the future.
Gorman Health Group has helped health plans, provider organizations, ACOs and countless others develop and execute on an implementation strategy that ensures every department has the processes, tools, and training needed to execute. From writing policies and procedures to stress testing your operations, from evaluating and expanding your network to implementing new tools that will help you manage your risk, GHG will partner with your leadership on every task, every step of the way.
Once a product strategy is established, the conversation must turn to benefits. Smart benefit design is a dynamic process that begins with an examination of intended markets with consideration given to strengths in member retention and medical management, and is executed with specific enrollment and financial targets in mind. Whether your organization is just entering the government programs space or is already well-established, our team is standing by to assist.
Sales, Marketing & Retention
We have an unparalleled track record working with clients in government programs to develop cost-effective strategies and tactics to help plans achieve maximum potential for their products. We build highly efficient marketing plans, from demographic analysis to material development. We’ve reviewed, rebuilt and re-contracted dozens of distributions channels, supporting clients with expert counsel and unique tools.
Gorman Health Group supports our clients in evaluating the efficiency, compliance, and strategic value of their risk adjustment programs from start to finish, and helps ensure that the procedures for capturing, processing and submitting risk adjustment data to CMS are accurate, timely, and complete. Whether you rely on multiple vendors or a largely internal team, GHG can help you streamline the execution of your risk adjustment approach, and build a roadmap to ensure you’re keeping pace with CMS expectations in both compliance and health care outcomes. Let’s make certain you are ready for that RADV audit when CMS calls.
We’ve developed strategic plans for organizations of all sizes and types. We begin with analytics of the market and a capacity assessment of your organization. The two must be considered in tandem. The environment may suggest one path, but a frank assessment of the organization suggests another. What is the interplay? From here we drive quickly to a practical action plan. Our deliverable doesn’t sit on a shelf. Our real deliverable is the process itself, led by plan veterans who have put concept into reality.