Skip to the main content.

Government Program Management for Healthcare

Ever-changing regulations in already complex government programs require deep expertise. From Medicare to Medicaid to exchange plans, we provide decades of experience with comprehensive medical and pharmacy technology, analytics and service solutions.

Navigating a Complex Landscape

Focus less on administration and operations, and more on member care with a wide range of tools, advanced analytics and administrative services from a health technology leader in government programs.

using laptop illustration


MA Strategies: Your Guide for Early and Ongoing Assessment

Medicare Advantage roadmap for annual member engagement/interval measurement, and strategies for leveraging demographic and other available data sources.

Case Study

Create a Proactive Plan to Assess Individual Health Needs

Humana Health Informatics uses the Johns Hopkins ACG® System for segmentation of their Medicaid population. See their results in this success guide.


Clinical Repository

Analyze enrich and abstract relevant information for HEDIS rate determination; ensure data accuracy, facilitate compliance and streamline HEDIS reporting.

Support Where You Need It Most

Core Administration Processing Technology and Services Government compliant software and operations with medical, prescription and enrollment platforms to administer coverage on all lines of business. Scalable and flexible technology so you can start a new line of business or outsource functions as needed.

Learn More

Total Cost of Care Management Population stratification, formulary optimization and specialty services are some of the solutions we offer that empower you to better understand and monitor the total cost of care for your members.

Learn More

Risk & Compliance Support of your oversight and monitoring activities with proactive software updates to meet government mandates along with deep knowledge of business requirements, not just technology needs.

Member and Provider Engagement Solutions to help you improve ease and delivery of care for your members and support your value-based provider arrangements.

Learn More

Revenue and Quality Optimization Analytics-driven and service solutions using industry-accepted standards to meet all required measuring and reporting, along with tools to monitor and optimize your revenue and quality.

Learn More