Medicare Advantage Leaders Gorman Health Group Announce New Venture Designed to Change Medicare Risk Adjustment

WASHINGTON, July 26, 2011 /PRNewswire/ -- Gorman Health Group and Censeo Holdings today announced a joint venture, CenseoHealth, headquartered in Fort Worth, TX.  The company provides a new model for mastering the risk adjustment payment of Medicare Advantage plans.  This program, centered on a house call program for chronically ill beneficiaries, represents a leap forward from the tools and techniques currently used by health plans.

CenseoHealth will offer targeted member analytics, a unique nationwide network of dedicated mobile physicians specializing in in-home evaluation of the chronically ill, compliant electronic medical record-keeping, and expert professional services in risk adjustment management.

"I have worked in risk adjustment since CMS implemented the program," said Dr. Jack McCallum, Chief Executive Officer of CenseoHeath.  "It has always struck me that the plans were missing out on an extraordinary opportunity to improve clinical outcomes by orienting their programs around the financial impact of risk adjustment.  We believe our service has a far greater long-term impact on revenue than traditional programs, and improves the quality of care delivered to members, not to mention the compliance of the plans' submissions."

"Risk adjustment remains the defining issue for Medicare Advantage plans and is central to improving the quality of care provided to chronically-ill beneficiaries," said John Gorman, Chief Executive Officer of Gorman Health Group. "The service we have designed is uniquely able to drive not only risk-adjusted revenue, but also quality Star Ratings and enhanced medical management."

"Given our extensive client base, Gorman Health Group has tremendous insight into the performance of vendors with similar programs.  We have done our due diligence and CenseoHealth is far and away the best," said Nathan Goldstein, Executive Vice President of Gorman Health Group.

For the last 15 years, Gorman Health Group has been the leading consulting and solutions provider to companies in Medicare Advantage and Part D.  Gorman launched an early market-leading venture in Medicare Advantage risk adjustment before selling the company in 2007. Censeo Holdings was founded by Dr. Jack McCallum, another founder in that venture, with the creator of the physician recruiting arm of Merritt Hawkins, the pre-eminent physician recruiting service before its sale in 2005.

About Gorman Health Group |

Gorman Health Group is a national health care professional services firm staffed by subject-matter experts, former health plan executives and seasoned regulators. For 15 years, hundreds of clients serving millions of beneficiaries have leveraged the strategic counsel and technology solutions of GHG to achieve growth objectives, maintain compliant operations, improve market position, and advance growth and profitability objective. Learn more at

For more information:
Rebecca Potts
Gorman Health Group, LLC
(202) 364-8283
[email protected]

SOURCE Gorman Health Group