Medicare Advantage | Medicare Part D | Managed Medicaid

Leading Provider of Business Process
Outsourcing Solutions to the
Government Health Plan Market

Who We Are

TMG Health is the leading national provider of Business Process Outsource solutions for Medicare Advantage, Part D and Managed Medicaid plans. With more than 18 years of experience of providing technology-enabled services to the government market exclusively, our knowledge of health plan processes, State & Federal regulatory requirements and the daily challenges plans face within the government market is second to none.

Our Expert Solutions

TMG Health is the leading national provider of Business Process Outsource solutions for government sponsored health plans. Our best-in-class technology and subject matter expertise deliver superior results for any or all of your critical services for:

  • Medicare Advantage
  • Managed Medicaid
  • Medicare Part D

Your Trusted Partner

We have successfully navigated the changes for both large and small plans for more than 18 years. Our proven solutions support:

  • Growth in Medicare, Medicaid, Dual Eligibles & Medicare Part D
  • Stringent MLR Requirements
  • Strict Compliance Requirements
  • Information Management & Reporting
  • Medical Management

Industry News… View All

  • News Scroll

    September 19, 2016 - TMG Health, Inc.
    Kolata will oversee all client implementations and is responsible for the development and negotiation of client contracts and pricing proposals:
    September 15, 2016 - USA Today:
    In the first legislative response to the EpiPen pricing furor, a bipartisan group of Senate & House members plan to introduce a bill, Thursday- September 16, that would force drugmakers to tell DHHS why any price hike of more than 10% is justified at least a month before the increase:
    September 12, 2016 - Bio Pharma DIVE:
    Express Scripts is tackling high drug costs with another of its SafeguardRx Solutions value programs, with a stated aim to control the costs of inflammatory disease for patients through formulary management, patient support and refunds.
    September 13, 2016 -
    The open enrollment period is your opportunity to review your current health needs and make adjustments based on your current needs and health care costs:
    September 8, 2016 - Phoenix Business Journal :
    BCBS Arizona has indicated it wont leave 10,000 Obamacare enrollees without coverage in Pinal County.
    September 1, 2016 - Kaiser Health News:
    Following weeks of criticism over dramatic price increases on its EpiPen, Mylan said Monday it will offer a generic version of the life-saving allergy treatment. The generic, which the company says will be identical to the brand product, will sell for $300 for a two-pack, which is half the cost of Mylan's brand name EpiPens.
    August 29, 2016 - Business Wire:
    Walgreens & Prime Therapeutics, A pharmacy benefits manager, today announced a long-term strategic alliance that forms a new retail pharmacy network agreement and the combination of the companies' central specialty pharmacy and mail service business.
    August 29, 2016 - Business Insider
    Two of the biggest problems for the exchanges have been a lack of young people, who help offset higher-cost patients, signing up for insurance and generally sicker-than-expected people getting coverage through the exchanges, leading to huge losses for some insurers.
    August 8, 2016 -
    Pricing of and access to medication are handled in an insane manner in the United States. It has been said that between 20 and 30 percent of prescriptions are never filled, presumably because of cost or access issues:
    August 4, 2016 -
    Enrolling in Medicare can be stressful and confusing, but delay signing up and it can set you back a bundle. Late enrollment penalties can hike a monthly premium by 10% or more - for the rest of your life.
    August 8, 2016 - Bidness, ETC.
    In 2017, Express Scripts Holding Company plans to add a minimal number of drugs in its formulary for the treatment of arthritis and psoriasis. On the other hand, the Pharmacy Benefit Manager, (PBM), will exclude a number of blockbuster drugs from the list next year.
    August 4, 2016 - Globe News Wire
    TMG Health, the leading national provider of business process outsourcing solutions to the Medicare Advantage, Medicare Part D and Managed Medicaid markets, announces the appointment of John Sanders as Vice President of Customer Service:
    August 2016 - Managed Care Magazine:
    A woman at the top is unusual in big business in the U.S. and around the world. Only 5% of America\'s largest businesses have women CEO's, according to several studies.
TMG Health, Inc.
100 Four Falls Corporate Center – Suite 406
Conshohocken, PA 19428