Medicare Advantage | Medicare Part D | Managed Medicaid

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

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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 19 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 19 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

    Combination of TMG Health Capabilities and TriZetto Software Will Enable Cognizant to Offer Enhanced Business Process Platforms and Services for Government and Public Health Programs
    June 1, 2017 - BCBS Of Texas:
    BCBS of Texas announced today it has acquired certain Medicare Advantage and Commercial Group Membership from Allegian Health Plans, a wholly-owned subsidiary of Tenet Healthcare.
    All regulatory requirements have been satisfied for BCBSTX and Allegian to complete this transaction. This transaction includes nearly 20,000 members enrolled through small, medium and large employer groups, as well as Medicare Advantage Plans.
    May 30, 2017 - Health Data Management:
    By the time a heart failure patient arrives at a hospital's emergency department in distress, it's too late to reverse progression of the often-fatal condition.
    Early detection is essential, but doctors have few existing tools. "It's a very insidious disease", said Walter Stewart, VP & Chief Research Officer for Sutter Health in Sacramento, Calif. "It overlaps with other health problems". Some 50% of heart failure patients die within 5 years.
    June 1, 2017 - American Pharmacists Association:
    Express Scripts launched a test website in May to provide the uninsured with access to discounted drugs. The site, InsideRx, will also serve as a test of public cloud technology that the company is seeking to adopt more widely.
    May 30, 2017 - ABC News:
    Officials said Tuesday the Government is on track to meet a 2009 deadline for replacing Social Security Numbers on Medicare Cards with randomly generated digits and letters to protect seniors against identity theft. Planning for the massive transition has been underway for years:
    May 25, 2017 - AHIP
    One of the most prevalent conditions impacting our members is asthma, leading to both costs and stress for patients and their families. Asthma, when poorly managed, is a significant driver of often avoidable costs through increased hospitalizations and emergency department visits. While there is no cure, asthma symptoms can be mitigated through enhanced management strategies.
    April 26, 2017 - Health Leaders Media:
    The Industry 'Is so screwed up and it's ripe to be disrupted', says David Feinberg, MD, the CEO and President of Pennsylvania-based Geisinger Health System.
    May 3, 2017 - PR Newswire
    The 'Report' - Analyzes 7 years of drug utilization, price changes and overall spending. It shows that prescription drug spending has increased 10% annually for BCBS members since 2010, an overall rise of 73%.
    May 2, 2017 - PR Newswire/HCSC
    Health Care Service Corporation (HCSC), The nation's largest customer-owned health insurer, reached a new record for employee volunteer hours in 2016, totaling 110,413 hours, a cash equivalent of $2,665,369, as measured by the U.S. Bureau of Labor Statistics.
    April 3, 2017 - Becker's Hospital Review:
    The report, titled "Digital Affectability; Therapeutic Lens on Value", details the economic potential of using digital assets for disease prevention, intervention and monitoring in the life sciences sector. The Accenture team deduced digital initiatives will lead to $60 billion in economic opportunity after adjusting for risk, translating to $24,184 per patient.
    March 22, 2017 - Business Wire:
    Mr. Murphy comes to Affinity with extensive experience leading public and private healthcare organizations. He was most recently at Aetna, one of the nation's leading diversified healthcare benefits companies, where he oversaw a multi-state, $4 Billion region that included Medicaid programs.
    March 8, 2017 - Health Day:
    Between 1999 and 2012 Salt (Sodium) consumption rose from about 2,900 milligrams a day to 3,350 milligrams a day. That's more than double the ideal upper limit of 1,500 milligrams a day of sodium recommended by the American Heart Association for people with high blood pressure (hypertension).
TMG Health, Inc.
100 Four Falls Corporate Center – Suite 406
Conshohocken, PA 19428
 1-800-331-4314