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

    November 18, 2016 - PR Newswire:
    The company was honored for its Taking On Asthma initiative, most notably, its collaboration with the American Lung Association of the Upper Midwest for the Enhancing Care for Children With Asthma Program.
    November 10, 2016 AHIP News:
    The five new members are:
    John Baackes - CEO of L.A. Care Health Plan
    Thomas A. Croswell - President & CEO of Tufts Health Plan
    J.D. Hickey, M.D. - CEO of BCBS Tennessee
    Pamela Morris - President & CEO of CareSource
    Michael F. Neidorff - Chairman, President & Ceo of Centene Corp.
    WAYNE, PA--(Marketwired - November 09, 2016) - Medecision, the leader in population health management for risk-bearing healthcare organizations, today announced it has received Disease Management (DM) Systems Certification recertification for 17 of its disease-management programs from the National Committee for Quality Assurance (NCQA). The certification, which runs through 2018, recognizes companies and systems that excel in the design of clinical information systems that support the management of the most complex, costly and high-risk patient populations.
    October 25, 2016 - TMG Health :
    Coffman will serve as liaison with customers and government agencies for the Medicaid activities of the company. He is responsible for responding to official inquiries, clarifying and interpreting compliance rules and overseeing preparation for and monitoring audits.
    October 13, 2016 - Fortune:
    Hospitals make money when patients show up to receive services, but Kaiser Permanente isn't convinced that's the only way to run its health care business.
    October 7, 2016 - Stevens Point City Times:
    Network Health, the Wisconsin-based health plan, has received a prestigious 4.5 star rating for its Medicare Advantage PPO plans from the Centers for Medicare and Medicaid Services (CMS). This rating reflects the quality of coverage offered by Network Health Medicare Advantage PPO plan, as well as a high level of customer satisfaction.
    October 8, 2016 -
    Blue Cross Blue Shield of Montana will start operations Monday (October 10) at its new headquarters in the Mountain View Meadows subdivision. Leaders say the move will be in several stages and should be finished in about two weeks.
    October 5, 2016 - Kaiser Health News:
    The goal is lofty and expansive; to cure, prevent or manage all known diseases by the end of the century. Facebook Chief Executive Officer, Mark Zuckerberg and his wife, pediatrician Priscilla Chan, announced last month that they planned to invest $3 billion over 10 years to begin tackling everything from Alzheimer's disease to the Zika virus.
    October 6, 2016 - AP Associated Press:
    The Obama administration is worried that insurers bailing out of the health law's markets may prompt their customers to drop out, too. So it plans to match affected consumers with remaining insurance companies:
    October 4, 2016 - CBS News:
    Baby boomers are expected to need more in-home care as they age, but federal investigators are now raising an alarm over what they call persistent fraud and abuse in Medicaid-funded personal care services.
    October 1, 2016 - The New York Times;
    A growing proportion of Medicare beneficiaries are opting out of the government-run insurance program. They are instead choosing a private-plan alternative, one of the Medicare Advantage Plans. The strength of this trend defies predictions from the Congressional Budget Office, and nobody can fully explain it.
    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.
TMG Health, Inc.
100 Four Falls Corporate Center – Suite 406
Conshohocken, PA 19428