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Home > Investing > Finance & Insurance News > GORMAN HEALTH GROUP STRENGTHENS RISK ADJUSTMENT EXPERTISE AND SOLUTIONS THROUGH PULSE8 ANALYTICS AND TECHNOLOGIES

GORMAN HEALTH GROUP STRENGTHENS RISK ADJUSTMENT EXPERTISE AND SOLUTIONS THROUGH PULSE8 ANALYTICS AND TECHNOLOGIES

Posted on: November 29, 2015 By: Insurance Updates

WASHINGTON, DC, Nov. 30, 2015 (GLOBE NEWSWIRE) — Gorman Health Group, LLC (GHG), the leading consulting firm and solutions provider in government healthcare programs, announced its new collaboration with Pulse8, an innovative healthcare analytics and technology company. This new collaborative will assist our health plan and provider clients who participate in Medicare, Medicaid, and Commercial Health Insurance Marketplace programs in their efforts to reduce administrative spend and improve revenue and quality objectives.

Accountability for quality is reaching across the whole landscape of healthcare delivery, making metrics-based transparency more the rule than the exception. Health plans and providers will need to develop strategies which assess financial exposure and estimate risk-based reimbursement – mining the data to leverage the analytics you already have is a good way to start.

 

“Analytics can be overwhelming, and, as premiums continue to be reduced, health plans and capitated medical groups must have strategies in place to ensure risk adjustment data accuracy,” said Daniel Weinrieb, Senior Vice President of Healthcare Analytics & Risk Adjustment Solutions at GHG. “Our new offering will continue to highlight the importance of applying actionable analytics to efficient, compliant risk adjustment programs and interventions. Pulse8’s sophisticated analytics and approach to using data to make informed business decisions are a natural fit.”

 

Health plans and providers have the source data but aren’t structured internally to maximize and leverage the information in a streamlined, efficient way. We will pinpoint key areas of improvement, assess your readiness, and provide a strategy to leverage technology, analytics, and products to support your organization moving forward.

 

“Payers and providers face great uncertainty with the Affordable Care Act, Medicare Advantage, and Medicaid programs where numerous obstacles exist such as rate compression, Risk Adjustment Data Validation (RADV), and changing regulations, among others,” said John Criswell, Pulse8 CEO. “Pulse8’s advanced analytical and visualization software, combined with GHG’s expertise, will fill the gap, achieving optimal program levels.”

 

“Managing gaps in care for the chronically ill, paired with complete and accurate risk adjustment data, is a do-or-die cost and revenue management capability for health plans and providers in government programs,” said John Gorman, Founder & Executive Chairman at GHG. “We’re excited to team with Pulse8 to offer our clients a unique combination of analytics, technology, expertise, and our shared values on high-quality care for the most vulnerable beneficiaries.”

 

Together, we will further support health plans and providers in managing increasing healthcare costs and achieving payment accuracy while introducing new technology solutions to maximize analytics and streamline year-round risk management processes.

 

About Gorman Health Group | Gorman Health Group (GHG) is a leading consulting and software solutions firm specializing in government health programs, including Medicare managed care, Medicaid, and Health Insurance Marketplace opportunities. Since 1996, our unparalleled teams of subject matter experts, former health plan executives, and seasoned healthcare regulators have been providing strategic, operational, financial, and clinical services to the industry across a full spectrum of business needs. Further, our software solutions have continued to place efficient and compliant operations within our client’s reach. Learn more at www.gormanhealthgroup.com and follow us on Twitter @gormanhealth.

 

About Pulse8 | Pulse8 is the only healthcare analytics and technology company delivering complete visibility into the efficacy of your Risk Adjustment and Quality Management programs. We enable health plans and at-risk providers to achieve the greatest financial impact in the Health Insurance Marketplace, Medicare Advantage, and Medicaid markets. By combining advanced analytic methodologies with extensive health plan experience, Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment. Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. For more company information, visit us at www.Pulse8.com, or follow us on Twitter @Pulse8News.

Kristina D'Ambrosio

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