Gorman Health Group | In the News
16700
page-template,page-template-full_width,page-template-full_width-php,page,page-id-16700,ajax_fade,page_not_loaded,,wpb-js-composer js-comp-ver-5.4.2,vc_responsive
 

In the News

After another ACA repeal attempt fails, the GOP faces tough choices

As some mourn and others cheer the demise of the Graham-Cassidy bill, which aimed to repeal and replace the Affordable Care Act, there is little doubt in anyone’s mind that Republicans will continue their push for conservative healthcare reform.

Read the full article

Release Date: 10/3/2017

 


 

For Healthcare Consultants, Uncertainty is Good for Business

“A central tenet of our business is that uncertainty is good for business,” said John Gorman, a former CMS official who is now a D.C. consultant for health plans. His customers have been asking whether to offer products in the struggling insurance exchanges, enter the Medicaid market or expand their Medicare Advantage offerings—arguably the safest market for insurers.

Read the full article

Release Date: 8/26/2017

 


 

Medical Claims Spending Requirement Not Cutting Premiums

An Obamacare requirement that insurers spend at least 80 percent of premiums on medical claims may not have lowered premiums.

But consultants who work with insurers argue that it distorts their incentives. “If they’re doing what we want them to do—cut costs and rein in premiums, it’s likely that their loss ratios will fall,” which results in MLR liability, John Gorman, executive chairman of Gorman Health Group LLC, told Bloomberg BNA. Gorman, an ACA supporter, was assistant director of the Office of Managed Care in what is now the CMS during the Clinton administration. Gorman’s company works with health insurers on meeting the MLR.

Read the full article

Release Date: 7/14/2017

 


 

Industry Hopeful Senate Health Care Debate Focuses on Policy, Not Politics

The health care industry is hopeful senators will be more receptive to outside groups than their House colleagues were, as the Senate takes the reins on overhauling the Affordable Care Act. “If there’s a thoughtful, deliberative process in the Senate that’s about policy and not politics, there’s going to be a lot more engagement with industry to try and get to a meaningful compromise here,” John Gorman, founder and executive chairman of the Gorman Health Group, a consulting firm focusing on the health insurance industry, said in an interview.

Read the full article

Release Date: 5/11/2017

 


 

Medicare Advantage plans score several wins in latest rates

Health insurance companies received a gift from the federal government earlier this week. The 2018 Medicare Advantage rate policies included better-than-expected pay bump and industry-friendly policies. The CMS “basically gave the plans everything they asked for,” said John Gorman, a former CMS official who is now a consultant in Washington. He added that the final notice was largely routine with no “earth-shattering” changes from the February proposal.

Read the full article

Release Date: 4/7/2017

 


 

Medicare Advantage plans to receive 0.45% rate hike for 2018

The federal government bumped up average pay raises for 2017 Medicare Advantage plans and modified several of the program’s policies in favor of the health insurance industry. The better-than-expected final rates are “a big sigh of relief” for the insurance industry, said John Gorman, a former CMS official who is now a healthcare consultant in Washington. The rates are “further proof that (Medicare Advantage) is the only safe game in all of health insurance these days.”

Read the full article

Release Date: 4/3/2017


Obamacare markets still face uncertainty despite Trumpcare flop

There’s still a black cloud hanging over the individual and small-group health insurance markets next year even though Republicans and President Trump failed to vote on and pass their health care bill. “Rather than play pin the tail on the donkey with nine-figure decisions, most would probably opt not to participate,” said John Gorman, a health insurance consultant and former official with the Centers for Medicare and Medicaid Services.

Read the full article

Release Date: 3/24/2017

 


 

Insurers Struggle to Plan for Future Amid Health Care Policy Vacuum

Health insurers have between two and three months to plan out what they’re doing in individual health markets next year, but last week’s implosion of the GOP health care bill has only added to uncertainty about the future of the marketplaces.

Read the full article

Release Date: 3/8/2017

 


 

Medicare Advantage Letter Applauded as Solid Backing

The 2018 Draft Call Letter for next year’s Medicare Part C and D programs is a breath of fresh air compared with the ACA, according to a new Gorman Group analysis. “The draft call letter came in better than expected, and provides fur-ther evidence that while President Trump throws grenades at Medicaid and ObamaCare, MA remains the only stable market in all of health insurance,” explains John Gorman, GHG Executive Chairman.

Read the full article

Release Date: 2/17/2017

 


Anthem Threatens Obamacare Retreat If Results Don’t Improve
Health insurer Anthem Inc., which has so far stuck with the Obamacare markets as rivals pulled back, said it may retreat in 2018 if its financial results under the program don’t improve next year. Anthem’s struggles “should be an alarm bell to policymakers,” said John Gorman, who advises health plans as founder of Gorman Health Group. “They’re real trend-setters in the individual market.”

Read the full article

Release Date: 11/2/2016

 


 

Data Disputes CMS’ Own MA Plan Projections

Health Plan Markets, Interpro Publications
The Centers for Medicare & Medicaid Services (CMS) released its annual Medicare Advantage (MA) and Part D “landscape files” with data on plans and bids for 2017 last week. “It’s a picture of programs that are rock-solid and driving insurers’ revenues and earnings, offering better supplemental benefits for no increase in price for two-thirds of beneficiaries,” experts at Gorman Group discovered after doing their usual detailed review. “CMS appears to be sandbagging its enrollment projections and assumed no growth for MA in 2017,” John Gorman explains. “We think we’re heading to 4.2-4.5% enrollment growth, continuing a steady, winning drumbeat for the industry.”

 

Read the full article

 

Release Date: 10/5/2016

 


 

Insurers in Three States to Test Medicare Managed Care Quality Program

Bloomberg Government

Health plans in just three of seven eligible states applied and won approval to
participate in a Medicare Advantage test program aimed at improving quality and reducing costs in
2017. “It’s a great development, and we’d like to see it evolve even faster,” John Gorman, chairman of Medicare Advantage consulting company Gorman Health Group, told Bloomberg BNA. “VBID is needed more in Medicare Advantage than anywhere else.”

 

 

Read the full article

 

Release Date: 10/5/2016

 


 

Consultants aggressively compete to help insurers use big data, manage costs

Modern Healthcare

This reliance on government programs has been a boon to boutique firms such as Gorman Health Group. “To function in this market, you have to understand all of the arcane rules that are in the various government programs,” said Lieberman, who has worked on risk adjustment since the 1990s. “You don’t learn this stuff in grad school.”

 

Read the full article

 

Release Date: 8/20/16

 


 

HealthPlanMarkets Issue 3 

Gorman Makes Long-Term Market Projections

The playing field of government programs “continues to expand rapidly, with improving revenue outlook across the board,” John Gorman says. During our interview he sees several years of positive revenue and incentive payments, but only for those companies able to adapt to accelerating market shifts.

 

Read the full article

 

Release Date: 5/9/16

 


 

Final Medicare Advantage rate policies a mixed bag for insurers

Did the Obama administration indulge health insurance companies with friendly changes to Medicare Advantage rate policies for 2017? Or did CMS officials stick to their guns on proposals the industry aggressively lobbied to kill? Experts say it was a little of both.

“It embodies the definition of compromise,” said John Gorman, a Washington-based Medicare Advantage consultant and former CMS official. “Everybody goes home pissed.”

 

Read the full article

 

Release Date: 4/8/16

 


 

Controversial home visits duck Medicare’s radar, for now

The most interesting thing about the preliminary rate notice for 2017 Medicare Advantage plans may be what federal policymakers left out. The thick document made no mention of health-risk assessments, which surprised the industry. The Obama administration and the Medicare Payment Advisory Commission have targeted the assessments for reform because they suspect plans use them to game the program’s risk scores and get paid more.

 

“It was the biggest shocker in this announcement,” said John Gorman, founder of health insurance consultancy Gorman Health Group and a former CMS official. “If (a change) was ever going to happen, it would be in the last year of the administration, when scores get settled.”

 

Read the full article

 

Release Date: 2/27/16

 


CMS Will Penalize health plans not ready for automated subsidy payments

Beginning next year, the CMS will pay premium and cost-sharing subsidies to exchange plans through an automated electronic process, and insurers that aren’t ready for it will be penalized.“If you think your organization has been working from a fire hose these past few years since the launch of the Health Insurance Marketplace, wait until the CMS rolls out policy-based payments to federally-facilitated marketplace issuers beginning in 2016,” Diane Fischer, a senior consultant at Gorman Health Group said.

Read the full article

 

Release Date: 12/8/15

 


 

Major Insurer Could Leave Obamacare Exchanges

UnitedHealth Group, the nation’s largest health insurer, is suddenly having second thoughts about Obamacare after it reported massive losses from the law’s new insurance marketplaces. John Gorman, an insurance consultant, said it’s disappointing that UnitedHealth is getting squeamish about the exchanges. Gorman, who said the company should have allowed three or four years for the marketplaces to stabilize, suggested the company is retreating because of Wall Street’s sensitivity to quarterly profits.

Read the full article

 

Release Date: 11/19/2015

 


 

CMS Admits Underpaying Dual-Eligible Health Plans

The CMS has revealed that it underpays health plans that enroll large numbers of people who are dually eligible for Medicare and Medicaid, and the agency plans to modify its risk-adjustment model to make up for the underpayment.“Up until a few weeks ago, CMS steadily maintained there wasn’t an issue, and on the stars issue, that plans needed to work harder, Gorman said. “And then at the AHIP conference, there was suddenly a big turnaround,” said John Gorman, Executive Chairman at Gorman Health Group.

 

Read the full article

 

Release Date: 11/6/2015

 


 

Consultant Sees Positive Environment for Medicare Advantage

MA enrollment has grown 7 percent annually, has reached 17 million beneficiaries and will be “north of 29 million” enrollees by the end of 2023, according to John Gorman, executive chairman, Gorman Health Group, LLC. In addition, “2016 is the first year where we see, in the aggregate, positive rates,” Gorman said at a conference sponsored by CAPG, an association of physicians who are part of capitated, coordinated care arrangements.The Centers for Medicare & Medicaid Services in April announced that Medicare Advantage rates will rise by an average 1.25 percent in 2016.

 

 

Read the full article

 

Release Date: 10/6/2015

 


 

Consultant Sees Positive Environment for Medicare Advantage

MA enrollment has grown 7 percent annually, has reached 17 million beneficiaries and will be “north of 29 million” enrollees by the end of 2023, according to John Gorman, executive chairman, Gorman Health Group, LLC. In addition, “2016 is the first year where we see, in the aggregate, positive rates,” Gorman said at a conference sponsored by CAPG, an association of physicians who are part of capitated, coordinated care arrangements.The Centers for Medicare & Medicaid Services in April announced that Medicare Advantage rates will rise by an average 1.25 percent in 2016.

 

 

Read the full article

 

Release Date: 10/5/2015

 


 

What a Difference a Year Makes! ‘Landscape Files’ Show MA Is Alive and Well

Even for those who saw it coming, the results are stunning. The 2016 Medicare Advantage “landscape files” released by CMS Sept. 21 show unmistakable signs of growth and health in an industry that many observers had earmarked for the graveyard in the aftermath of the passage of the Affordable Care Act (ACA) in 2010. Is Gorman Health Group, LLC Executive Chairman John Gorman right when he sees improvement for the industry’s fortunes in both 2016 and 2017, telling AIS that the 2016 files “underscore the value proposition of the one-stop shop that is MA”?

 

 

Read the full article

 

Release Date: 7/16/2015

 


 

Health Mergers Could Cut Consumer Options

The nation’s biggest health insurers, which are pursuing a series of potential megamergers, have market overlaps that could damp competition in sectors such as private Medicare plans, an analysis of state and federal data by The Wall Street Journal has found. John Gorman, a consultant to the health-care industry on Medicare issues, said that analyses such as the Journal’s are a first step in any insurance-merger due-diligence process. He said antitrust regulators would look closely at locations, but the overlap between Aetna and Humana wouldn’t likely be “enough to torpedo the deal; you may see some divestments, but not a mushroom cloud.”

 

Read the full article

 

Release Date: 6/21/2015

 


 

Bill Would Extend Life of low-rated Medicare Advantage Drug Plans

About 10,000 Southwest Florida seniors are enrolled in two poorly rated Medicare Advantage prescription drug plans that could be on the chopping block.“This is a market-based system that is supposed to work on basic evolutionary principles,” said John Gorman, founder and executive chairman of Gorman Health Group, a health insurance consulting firm in Washington, D.C. “If you can’t adapt, you’re left behind.”

 

Read the full article

 

Release Date: 6/17/2015

 


 

Insurers Playing A Game of Thrones

Big U.S. insurers are courting one another for possible multibillion-dollar deals. How they pair off could have significant implications for the managed-care industry, its individual and corporate customers, and U.S. medical providers. A deal for “any one of them is a seismic event in the industry” that could put outsize market power in the hands of one company, said John Gorman, an advisor to managed-care companies, including some of them now in the mix.

 

Read the full article

 

Release Date: 6/16/2015

 

 

 


 

CMS Soon to Release New Medicaid Managed Care Regulations

CMS plans to release an undisclosed proposal in the next few weeks that will overhaul the Medicaid managed care marketplace. Guidelines have not been updated since 2002. Since Medicaid managed care regulations were last updated in 2002, John Gorman, executive chairman and founder of the Gorman Health Group told Bloomberg BNA that “this is literally the biggest healthcare regulation in a dozen years.”

 

Read the full article

 

Release Date: 5/21/2015

 

 

 


 

CMS To Release Medicaid Managed Care “Uber Rule”

The CMS is poised to release in the coming weeks what stakeholders and advocates are calling an “uber rule” that will completely overhaul the Medicaid managed care marketplace. Medicaid managed care regulations haven’t been updated since 2002, so whatever CMS has in store is sure to touch on essentially every aspect of managed care. John Gorman, founder and executive chairman of the Gorman Health Group consulting firm told me “this is literally the biggest healthcare regulation in a dozen years.” Gorman said it’s even a bit of a misnomer to call it a Medicaid rule, since it will impact Medicare and Medicare Advantage. He said it’s better to think of the proposal as an “omnibus rule.”

 

Read the full article

 

Release Date: 5/20/2015

 

 

 


 

Lobbyists Ratcheting Up Efforts Before MA Rate Decisions

Cuts loom once again over provider payments for popular Medicare Advantage plans. And this year, more organizations than ever are lobbying to keep those cuts from going through. “The politics of this program changed pretty dramatically once it passed one third of all Medicare beneficiaries. That was a very important bit of demographic muscle,” said John Gorman, founder of Gorman Health Group, a consulting firm that works on MA issues. And that tipping point has benefited lobbyists and advocates. “It’s now got a lot more impact on the way CMS lays out policy in this annual exercise.”

 

Read the full article

 

Release Date: 4/6/2015

 

 

 


 

Medicare Advantage 2016 rate season begins

Medicare Advantage reimbursement and regulatory changes are coming, along with new probes into risk adjustment practices that could lead to settlements and clawbacks. As John Gorman, head of the Gorman Health Group, put it: risk adjustment data validation “just got real.”

 

Read the full article

 

Release Date: 2/20/2015

 

 

 


 

Behind the Curtain, Troubles Persist in Healthcare.gov 

The “back end” of the Obamacare website still isn’t properly wired to the health insurance companies. It’s slow going for health plans to make sure the 11.4 million people who have signed up end up in the right plan. Subsidy payments aren’t automated, so the insurers get payments based on estimates. And adding information like a marriage or the birth of a child is a convoluted, multi-step process.

 

Read the full article

 

Release Date: 2/17/2015

 

 

 


 

Should Medicare Negotiate Part D Drug Prices? Take our Reader Poll.

The rising cost of medicines is on the White House radar screen. In his budget proposal yesterday, President Barack Obama included a statement saying his “administration is deeply concerned with the rapidly growing prices of specialty and brand-name drugs. As one Beltway lobbyist told Bloomberg News, the proposal may well go nowhere fast. “Dead on arrival,” John Gorman told the news service. “This is red meat for the left. They don’t have a lot of chops to throw to these folks.”

 

Read the full article

 

Release Date: 2/3/2015

 

 

 


 

Drug Prices Prompt Obama to Call for Medicare Bargaining Power

President Barack Obama said the government should negotiate lower prices for expensive new medicines such as Gilead Sciences Inc.’s hepatitis C treatment Harvoni, breaking a detente with the drug industry on the issue. While Republicans control both chambers of the legislature and almost certainly won’t take up the idea, the proposal will please Obama’s liberal supporters, said John Gorman, executive chairman of Gorman Health Group, a lobbying and consulting firm in Washington. “Dead on arrival,” Gorman said of Obama’s proposal. “This is red meat for the left. They don’t have a lot of chops to throw to these folks.”

 

Read the full article

 

Release Date: 2/2/2015

 

 

 


 

California stumbles for shifting care to costly patients

California’s ambitious effort to save billions of dollars by changing how the state’s costliest patients get treated is on the ropes. The Obamacare program was designed to reduce medical costs by putting more of the nation’s 11 million most challenging and expensive patients into tightly managed care.”It’s been messy in California, but I really think those savings are there,” said Robb Cohen, a consultant at the Gorman Health Group in Washington. “There are billions of dollars on the table.”

 

Read the full article

 

Release Date: 1/31/2015

 

 

 


 

Bloomberg BNA’s 2015 Outlook on Health Care

With the Affordable Care Act’s health insurance exchanges now in their second year, and decisions expected in the coming months on ongoing legal challenges to health insurance premium tax credits for coverage through the Affordable Care, 2015 will be a critical year in the future of ACA implementation. Watch as experts, Nationally Timothy Jost, Joel Ario, John Gorman and Dan Durham, discuss top health insurance issues of 2015.

 

View the Recording

 

Release Date: 1/29/2015

 

 

 


 

Where Healthcare is now on march to value-based pay

U.S. healthcare providers and insurers start from widely divergent places as some of the largest move to put most of their business into payment models that reward lower cost and higher quality care. More insurers and providers may be willing to enter risk-based contracts with Medicare’s announced commitment, said John Gorman, a Washington-based consultant who works with health plans. “I think most insurers are doing the happy dance right now because this really means that contracting for a result or an outcome is really going mainstream if Medicare is doing it,” Gorman said. “And that will only encourage or force reluctant providers to come around.”

 

Read the full article

 

Release Date: 1/28/2015

 

 

 


 

 

 

SCOTUS, Republicans, Consumers to Determine Obamacare’s Success

While much of the attention during Obamacare’s rollout focused on the technological issues the government faced with its flagship website, smoother sign-ups for 2015 will allow policymakers, industry members and nonprofits to take a closer look at how the law is working for Americans. Republicans also are running Congress, and many have said their ultimate goal is to repeal the Affordable Care Act. Faced with Obama’s veto power, however, their focus for now will be on changing parts of the law. “I think the Republicans have overplayed their hand in going after the Affordable Care Act,” said John Gorman, founder and executive chairman of the Gorman Health Group, a consulting firm.

 

Read the full article

 

Release Date: 1/14/2015

 

 

 


 

 

 

2015 Outlook: Cost Savings From Duals Demos Are Likely to Be Slow in Coming

“Consultant John Gorman, executive chairman of Gorman Health Group, LLC, predicts that duals demo plans in 2015 will get more proactive in explaining both to providers and beneficiaries why the FAI is a good thing for them. Nevertheless, he tells MAN, the demo this year will prove “very, very difficult,” especially considering the “astounding number of opt-outs” the FAI has experienced so far (MAN 5/8/14, p. 1). Doctors have done a “very good job of scaring” duals away from participating in the demo, and this will make it hard to meet cost-savings targets, he asserts.” Found in a recent article featured in Medicare Advantage News. (Free for Medicare Advantage subscribers; $17 for non-subscribers).

 

Read the full article

 

Release Date: 1/13/2015

 

 

 


HEALTH INSURERS SEE MAJOR ISSUES WITH SOME CHANGES CMS WANTS FOR 2016 STARS 

“There are actually a lot of significant changes here that plans need to start budgeting and planning for almost immediately. Basically what we are seeing is the low-hanging fruit for stars measures is gone and this is becoming an annual exercise in climbing up the tree. This is going to require a fundamental integration of clinical and medical data by the plans and a really high degree of execution at the physician practice and pharmacy level, not just for the measures that are coming and on display next year, but for the measures that are coming in 2017,” explained John Gorman, founder and executive chairman at Gorman Health Group, in a recent article featured in AIS Health Plan Week. (Free for HPW subscribers; $17 for non-subscribers).

 

Read the full article

 

Release Date: 12/8/2014

 

 

 


 

 

 

CMS SCRUTINIZING MORE PRIVATE MEDICARE, BUT ARE ENFORCEMENT ACTIONS ENOUGH?

The recent spate of sanctions overwhelmingly involve questionable prior-authorization techniques for services or drugs, disputes over denied coverage and noncompliant formularies—in other words, Medicare beneficiaries incur unnecessary costs because their health plans create hurdles that shouldn’t exist. In the first 11 months of 2014, the CMS took 35 enforcement actions on insurers that provide Medicare Part C and D coverage. That’s more than any other year since the CMS beefed up its auditing strategy in 2010.

“That’s just embarrassing for this industry,” said John Gorman, a healthcare consultant and former CMS official. “The plans just keep screwing it up.”
 

 

Read the full article

 

Release Date: 12/4/2014

 

 

 


 

 

 

OBAMACARE CHALLENGE OVER SUBSIDIES GETS SUPREME COURT REVIEW

The U.S. Supreme Court agreed to consider a challenge to the subsidies that are a linchpin of President Barack Obama’s health-care overhaul, accepting a case that suddenly puts the landmark law under a new legal cloud.“That they even accepted it is not a good harbinger of what’s to come,” John Gorman, Founder and Executive Chairman of the Gorman Health Group, a Washington consulting firm, said.

 

Read the full article

 

Release Date: 11/7/2014

 

 

 


 

 

 

OBAMACARE TERMINATION ISSUE COULD MUDDLE RENEWALS 

Diane Fischer, a senior consultant at Gorman Health Group, works closely with health plans on the exchanges and has discussed their concerns over the termination notice issue for people changing plans. She says insurers “will have a challenging environment” because of the federal exchange’s current capabilities.

 

Read the full article

 

Release Date: 10/17/2014

 

 

 


 

 

 

EXPERTS: FACING THREAT FROM EMPLOYERS, HEALTH INSURERS SHOULD CONTINUE TO THINK LIKE PROVIDERS

With a potential increasing threat of some employers seeking to cut out health insurers from their employee benefits equation, experts say insurers should continue on the fast-track to accountable care organizations and think of themselves as health care providers.

Read the full article

 

Release Date: 10/09/2014

 

 

 


 

 

 

WHY ONE PIONEER ACO QUIT THE PROGRAM — AND WHAT IT REVEALS ABOUT THE ACA

While most media coverage of the ACA has focused on the law’s coverage expansion provisions, the triple aim underpinning Obamacare also included two other important objectives — lowering health care costs and boosting quality.

Read the full article

 

Release Date: 9/24/2014

 

 

 


 

 

 

CMS GRANTS LOW-STAR MEDICARE ADVANTAGE PLANS MERCY, FOR NOW

Struggling Medicare Advantage and Part D drug plans are being given a last minute reprieve, although they will need to show more improvement if they want to stay alive longer than a year.
Read the full article

 

Release Date: 09/18/2014

 

 

 


 

 

 

SHARP HEALTHCARE ACO DROPS OUT OF MEDICARE’S PIONEER PROGRAM

John Gorman, founder of healthcare consulting firm, Gorman Health Group, thinks more will drop out. And he attributes the skepticism to the CMS payment benchmarking.
Read the full article

 

Release Date: 08/27/2014

 

 

 


 

 

 

PBMS THREATEN SUSTAINABILITY OF MEDICARE, PART D PLANS

Evidence from recent federal enforcement actions suggest pharmacy benefit managers are exposing public-payer managed care plans to problems that could send shivers up executive’s spines.
Read the full article

 

Release Date: 07/16/2014

 

 

 


 

 

 

UNITEDHEALTH CONTINUES TO CUT MEDICARE ADVANTAGE PROVIDERS

UnitedHealth Group is continuing to eliminate doctors from its provider networks for Medicare Advantage plans in states across the country. GHG Executive Chairman, John Gorman believes United will not be the only insurer to start trimming its networks.
Read the full article

 

Release Date: 06/17/2014

 

 

 


 

 

 

GHG FORECASTS MA RATE PRESSURE COULD PERSIST IN 2016

On Friday afternoon, we participated in a Gorman Health Group webinar in which the health consulting firm provided its assessment of the final 2015 Medicare Advantage rate proposal released by CMS on April 7.

Read the full article

 

Release Date:  04/14/2014

 

 

 


 

 

 

MEDICARE ADVANTAGE AND THE ‘POTOMAC TWO-STEP’

John Gorman, the founder of the consulting firm Gorman Health Group who worked in CMS’ predecessor with Medicare and Medicaid managed plans, says it was more political strategy than not.
Read the full article

 

Release Date: 04/14/2014

 

 

 


 

 

 

INSURERS STILL SEE MEDICARE ADVANTAGE CUTS ON THE HORIZON

Insurers and Wall Street analysts still see cuts ahead for Medicare Advantage plans even though the Obama administration says that tweaks to its draft policy mean the rates will rise.

Read the full article

 

Release Date:  04/12/2014

 

 

 


 

 

 

MEDICARE ADVANTAGE RATES IN 2015 NOT A CLEAR-CUT WIN FOR INSURERS

“It’s not as rosy a picture as the initial reports, there’s some hooks in the pie here,” said John Gorman.
Read More

 

Release Date: 04/08/2014

 

 

 


 

 

 

HOME HEALTH ASSESSMENT FIRMS MAY HAVE TO ADJUST IF MA CALL LETTER FINALIZED

Read the full article

 

Release Date: 03/19/2014

 

 

 


 

 

 

NOVU LAUNCHES SMOKING CESSATION PROGRAM TO HELP SMOKERS SUCCESSFULLY QUIT AND LEAD HEALTHIER LIVES

Novu, announced today that its new smoking cessation program is now available on the online Novu consumer health engagement and rewards platform.

Read the full article

 

Release Date: 03/12/2014

 

 

 


 

 

 

TOP CHALLENGES HEALTH PLANS FACE WHEN SUBMITTING THEIR APPLICATION TO CMS

Read More

 

Release Date: 03/06/2014

 

 

 


 

 

 

OBAMA SAID TO ALLOW TWO-YEAR RENEWAL FOR OLD HEALTH PLANS

Read the full article

 

Bloomberg

Release Date: 03/05/2014

 

 

 


 

 

 

GOVERNMENT PROPOSES CUTS TO INSURERS’ MEDICARE PAYMENTS

CMS also declined to head off some other reductions that the industry had hoped might be blunted. The agency won’t extend a program that had resulted in extra payouts to health plans based on their scores on certain quality measures.
Read the full article

 

Release Date: 02/22/2014

 

 

 


 

 

 

INSURERS NERVOUSLY AWAIT PROPOSED MEDICARE ADVANTAGE RATES

Traditionally, Medicare has spent significantly more per capita for Advantage enrollees than for beneficiaries in traditional Medicare. Cuts that were part of the Patient Protection and Affordable Care Act were designed to eliminate that disparity. But in 2013, Advantage enrollees still cost 4% more.
Read the full article

 

Release Date: 02/19/2014

 

 

 


 

 

 

HEALTH PARTNERS SURPASSES MEDICARE ENROLLMENT EXPECTATIONS

Read the full article

 

Release Date:  01/23/2014

 

 

 


 

 

 

JOHN GORMAN SPEAKS AT BLOOMBERG BNA 2014 OUTLOOK ON HEALTHCARE CONFERENCE

Read the full article

 

Release Date:  01/23/2014

 

 

 


 

 

 

OBAMACARE CRASHES MONTHS IN COMING NOT EASILY REPAIRED

John Gorman, Gorman Health Group Executive Chairman, mentioned in Bloomberg’s article: Obamacare Crashes Months in Coming Not Easily Repaired

Read the full article

 

Release Date:  01/23/2014

 

 

 


AS OPEN ENROLLMENT KICKS OFF, MEDICARE ADVANTAGE ‘REMARKABLY COMPETITIVE’ DESPITE ACA-RELATED CUTS

John Gorman, Executive Chairman at Gorman Health Group, mentioned in BestWeek article: As Open Enrollment Kicks off, Medicare Advantage ‘Remarkably Competitive’ despite ACA-related Cuts

Read the full article

 

Release Date:  10/24/2013

 

 

 


 

 

 

GOT MEDIGAP? IT’S GONNA COST YOU, AND IT’S GONNA COST MEDICARE

“As John Gorman, the executive chairman of Gorman Health Group told me, Medigap plans are purely volume-based, and basically fly in the face of Medicare payment reform efforts.”

Read the full article

 

Release Date:  10/24/2013

 

 

 


 

 

 

FEDERAL EXCHANGES WOES MAY TAKE CENTER STATE AS HILL THREAT TO HEALTH LAW FADES

John Gorman, a former CMS official who heads the Gorman Health Group consulting firm, said “I suspect the administration’s not talking about these things to avoid giving [Tea Party supporters] a talking point when they’re about to get rolled on the Hill. There is a ton of fix and workaround activity going on though, so we hear.”
Read the full article

 

Release Date: 10/16/2013

 

 

 


 

 

 

TECHNICAL GLITCHES SNARL SILVER STATE HEALTH INSURANCE EXCHANGE

Gorman Health Group mentioned in Las Vegas Journal-Review article: Technical Glitches Snarl Silver State Health Insurance Exchange
Read the full article

 

Release Date: 10/14/2013

 

 

 


 

 

 

SOFTWARE, DESIGN DEFECTS CRIPPLE HEALTH CARE WEBSITE

Six days into the launch of insurance marketplaces created by the new health-care law, the federal government acknowledged for the first time Sunday it needed to fix design and software problems that have kept customers from applying online for coverage.
Read the full article

 

Release Date: 10/07/2013

 

 

 


 

 

 

GORMAN HEALTH GROUP MENTIONED IN PHYSICIANS NEWS NETWORK ARTICLE: FORMER PRESIDENT ADDRESSES CAPG IN LA

Read the full article

 

Release Date:  06/11/2013

 

 

 


 

 

 

LAX POLICING OF DOCTOR AND PHARMACY CONFLICTS IS FOUND IN MEDICARE COVERAGE DECISIONS

WASHINGTON — Deciding which drugs will be covered by Medicare can influence huge amounts of spending, but government officials do little to police conflict of interest among doctors and pharmacists who make those decisions, federal investigators said Monday. By Robert Pear, New York Times
Read the full article

 

Release Date: 03/05/2013

 

 

 


OBAMACARE: FOR STATE REPUBLICANS, IT’S DECISION TIME

Bloomberg Businessweek. Published December 6, 2012. Written by Devin Leonard
Read the full article

 

Release Date: 12/12/2012

 

 

 


 

 

 

DESPITE DEMOCRATS’ WARNINGS, PRIVATE MEDICARE PLANS FIND SUCCESS

The New York Times. Published August 25, 2012. Written by Robert Pear
Read the full article

 

Release Date: 08/25/2012