Resource Library

Latest insights from every strategic and operational area in Government sponsored health programs

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.

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Industry Alerts

2022 Advance Notice Part I Released, Heavy Focus on Risk Adjustment

On September 14th, CMS published the 2022 Advance Notice Part I, with particular emphasis on Risk Adjustment. One key takeaway from this announcement is that CMS will push forward with their plan to…

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Insights

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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Part II of the CY 2022 Advanced Notice: Continued Evolution of the Medicare Advantage Star Ratings

CMS recently surprised plans with the early release of Part II of the CY2022 Advance Notice, with several updates impacting Star Ratings. GHG's Jessica Assefa summarizes the noteworthy changes here.

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