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

    • June 21, 2016 - CNBC:
      "Last year high-cost specialty drugs was the main driver of trends. This year, it's more utilization that's driving trends", said PwC Partner, Barbara Gniewek.
    • June 20, 2016 - Becker's Hospital Review:
      Value-Based reimbursement models are taking root at hospitals, health systems, and health insurance companies across the nation.
    • June 21, 2016 - USA Today:
      Potential roadblocks to the planned $48.2 Billion merger of health insurance giants Anthem & Cigna are piling up, leaving the outcome uncertain nearly a year after it was announced.
    • June 20, 2016 -
      Modern Health magazine polled 110 leaders of hospitals, insurance companies, physician groups, and other non profit organizations.
    • June 20, 2016 - Morning Consult:
      A crippling $72 Billion debt has brought the island to the worst fiscal and economic crisis on record.
    • May 10, 2016 - Louisville Business First:
      Cars today can park themselves, and soon might be able to drive themselves, but that won't work for health care.
      At least, not in the opinion of Humana Inc.'s CEO, Bruce Broussard. He wrote a linked-in post on whether automation, such as the kind that drives the Google Self-Driving car, could disrupt the health care industry.
    • March 30, 2016 - Health Leaders Media:
      Healthcare information and security officers are leading efforts to avoid cyberattacks through training and tools as 81% of healthcare executives say that their organizations' systems have been compromised during the past two years.
    • May 8, 2016 - The Fiscal Times:
      Medicaid managers have done little to stem rampant fraud in the massive government health care program for the poor, which totaled more than $29 Billion last year, according to a new government accountability office (GAO) report to congress.
    • May 11, 2016 - HCSC- Dow Jones:
      Modern medical training does not include much education about the healthcare system, financing the system, or physician reimbursement.
    • May 2, 2016 - Sellers-Dorsey:
      The full rule is massive and addresses a wide variety of other issues, including medical loss ratio, network adequacy, beneficiary protections, managed long term services & supports, and capitation rates.
TMG Health, Inc.
455 S. Gulph Road, Suite 307 King of Prussia, PA 19406