About

Gorman Health Group is now GHG Advisors

More than 200 health plan clients and an additional broad range of other industry participants each year trust GHG’s team of professionals to deliver expert counsel and tools to help them meet their goals.

We pride ourselves on having both day-to-day alignment with the latest CMS guidance and the long-term strategic vision to keep it all in perspective.

Our mission as the industry’s most active professional services consultancy and provider of technology-based solutions is to empower health plans and providers to deliver higher quality care to beneficiaries at lower costs, while serving as valued, trusted partners to government health agencies.

Grow. Perform. Transform.

GHG is the leading solutions and consulting firm for government-sponsored health programs. Our experts consist of seasoned veterans who have served at every decision making level of leading health plans, PBMs and state and federal agencies. Collectively our staff members have thousands of years of experience in every functional area of a health plan and their business partners. No other firm can boast of such a complete view of the industry from policy and politics to resolution to efficient and compliant private sector operations.

Everybody’s got a story, here’s ours

In 1996, GHG Founder & Executive Chairman John Gorman left his post as Assistant to the Director of HCFA’s Office of Managed Care and founded Managed Care Compliance Solutions (MCCS) to provide Medicare regulatory compliance advisory services to health care payers. Following the enactment of the federal Balanced Budget Act (BBA) of 1997, demand for MCCS’ services grew among managed care plans in tandem with the rapid growth of the Medicare+Choice program. In 2001, following a period in which interest among payers in the Medicare+Choice program had waned, MCCS reorganized in anticipation of the pendulum’s return, and hired key managed care executives to head up the company’s product development and marketing and sales capabilities. One of these was Tom Anderson, the former Chief Government Programs Officer for United Healthcare’s corporate office, who encouraged John to think more globally about the industry and its prospects. The two mapped out a design for a Medicare PPO product, and an early blueprint for what would later become the Special Needs Plan with an emphasis on dual eligibles. With its broader focus on government programs, in 2002, MCCS was reintroduced to the industry as Gorman Health Group. That same year, a majority of the managed care organizations that chose to participate in HCFA’s Medicare PPO Demonstration program turned to GHG for assistance.

BY THE NUMBERS

One-Stop Access to Expert Advice

Guidance and support in every strategic and operational area in Government sponsored health programs


25

YEARS

572

CLIENTS

221

CONSULTANTS

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INSIGHTS

GHG Healthcare Perspectives

Four medical professionals meet to discuss strategy

With Switching Down, MAOs Seek ‘Untapped’ Market Segments

AIS Health recently spoke with GHG's Vice President, John Selby, about his analysis of the 2021 Medicare Annual Election Period.

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2021 Risk Adjustment Strategy and Program Readiness

The COVID-19 pandemic put a strain on the entire healthcare industry and, for risk adjustment in particular, the disruption caused by the pandemic resulted in both positive and negative effects. Here…

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CMS Program Audit Universes and Protocol Changes Tabled Until 2022

CMS recently released the 2021 Program Audit Memo announcing that it will start sending engagement letters in March 2021, but health plans should remain diligent about audit preparation and their PBM…

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