WASHINGTON – March 18, 2015. Gorman Health Group, LLC (GHG), the leading consulting firm and solutions provider in government healthcare programs, announced its new vision for maximizing healthcare analytics and optimizing risk adjustment programs, relying heavily on patient/member, health plan, and provider collaboration, and the appointment of one of the nation’s leading risk adjustment experts, Daniel Weinrieb, to lead the division.
Daniel has proven experience and demonstrated success in leading health plans and providers in their efforts to achieve superior performance outcomes in the areas of revenue capture, medical trend management, quality improvement, and population health. As Senior Vice President of GHG’s Healthcare Analytics and Risk Adjustment Solutions division, Daniel and his team will support health plan and provider clients assess, design, implement, and manage analytics and risk adjustment initiatives.
The division will provide enterprise-wide services to plans in order to address risk revenue, quality, and trend across all departments and align with the Centers for Medicare & Medicaid Services’ (CMS’) recent proposed changes and forecasted rules.
“CMS has a new vision for risk adjustment; the process will need to expand beyond the historic exercise of chasing charts and collecting codes,” explained Weinrieb. “Population health, clinical quality outcomes, and medical management will all need to be integrated components of any successful, compliant healthcare delivery system’s approach to risk adjustment. We’ve aligned our service offerings with this vision in mind – relying heavily on analytics to drive targeted efforts and collaborative partnerships between health plans and network providers.”
We offer tailored solutions that will help the industry leverage the investments they have made in technology, vendor relationships, and program infrastructure, streamlining processes for risk adjustment and integrating the data that is readily available but lost in the shuffle.
“Ensuring risk score accuracy and silo-busting strategies to manage healthcare costs and achieve quality improvement has never been more critical to health plan competitiveness and viability,” explained John Gorman, Executive Chairman of GHG. “CMS recently laid out eight key components and recommendations for the evolution of home visits. Implementing those suggestions and embedding risk adjustment in medical management will essentially audit-proof a health plan from the dreaded RADV audit surge that is coming.”
With more than a decade of experience, Daniel led health plan and network efforts to redesign risk adjustment strategies and foster the inclusion of cross-functional technology and analytics. His expertise in vendor selection, management, and oversight, coupled with program design and implementation for risk adjustment, has yielded operational efficiencies and financial and quality improvement.
In his role as Senior Vice President of Healthcare Analytics and Risk Adjustment Solutions, Daniel will provide expert guidance on how to integrate data and processes in order to support Risk Adjustment initiatives as well as superior clinical and operational performance outcomes to drive quality improvement standards, manage healthcare costs, and ensure revenue generation,” added Gorman.
About Gorman Health Group | www.gormanhealthgroup.com Gorman Health Group is a national healthcare professional services and software company staffed by subject matter experts, former health plan executives, and seasoned regulators. For nearly 20 years, hundreds of clients serving millions of beneficiaries have leveraged the strategic counsel and technology solutions of GHG to maintain compliant operations, improve market position, and advance growth objectives. GHG’s solutions continually evolve to meet the needs of our clients. Learn more at www.gormanhealthgroup.com.
Release Date: 3/18/2015