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# Convey Health Solutions

Technology, Analytics, and Advisory

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## Posts

- [Michael DiSimone](https://conveyhealthsolutions.com/michael-disimone/) - Michael DiSimone is the Chief Executive Officer of Convey Health Solutions.
- [Sagility Announces Strategic Alliance with Convey Health Solutions and Simplify Healthcare® to Launch Sagility Synchrony](https://conveyhealthsolutions.com/insights/convey-health-solutions-sagility-partnership/) - Convey Health Solutions joins Sagility and Simplify Healthcare in launching Sagility Synchrony, a more connected approach to Medicare Advantage operations.
- [Convey Health Solutions Enterprise Technology Platform Now Serves Over 4 Million Medicare Members](https://conveyhealthsolutions.com/insights/convey-health-solutions-enterprise-technology-platform-now-serves-over-4-million-medicare-members/) - FORT LAUDERDALE, FL (BUSINESS WIRE) – May 25, 2018 – Convey Health Solutions (“Convey”) announced today as a result of recent client wins that Miramar, Convey’s proprietary technology platform, serves over 4 million Medicare members in the Medicare Advantage, Medicare Part D, Employer Group Waiver Plan, and Prescription Drug markets. Miramar includes six fully integrated
- [Convey Health Solutions Strengthens Miramar Technology Platform with Sentinel Elite Agent Management Module](https://conveyhealthsolutions.com/insights/convey-strengthens-miramar-technology-platform-with-sentinel-elite-agent-management-module/) - FORT LAUDERDALE, FL (BUSINESSWIRE) – June 18, 2019 – Convey Health Solutions (Convey), a market-leading healthcare technology and services company, recently announced the rebranding of Sentinel Elite. Sentinel Elite provides agent oversight and management capabilities to over 33 health plans, encompassing approximately 300 unique programs, and serves more than 30,000 agents. Sentinel Elite is now
- [Convey’s Over-The-Counter Benefit Supports Health Plan Growth](https://conveyhealthsolutions.com/insights/conveys-otc-benefit-supports-health-plan-growth/) - Big Data Made Actionable FORT LAUDERDALE, FL (BUSINESS WIRE)–Convey Health Solutions (Convey), a leading provider of technology-enabled and advisory solutions for health plans, today announced the results of its research on the use of supplemental benefits in the Medicare Advantage (MA) marketplace. Utilizing its Pareto Intelligence Spotlight (Pareto Spotlight) technology, a data analytics solution, Convey
- [Convey Health Solutions to Combine With HealthScape Advisors & Pareto Intelligence](https://conveyhealthsolutions.com/insights/convey-health-solutions-to-combine-with-healthscape-advisors-and-pareto-intelligence/) - Merger Creates Leading Healthcare Payor-Focused Technology Solutions Company; Positions Company for Continued Innovation and Accelerating Growth. Fort Lauderdale, FL, and Chicago, IL, (BUSINESS WIRE) – November 16, 2018) – Convey Health Solutions (“Convey”) today announced an agreement to merge with HealthScape Advisors, LLC (“HealthScape”) and Pareto Intelligence LLC (“Pareto”), combining Convey’s market-leading set of compliant,
- [Convey Health Solutions Announces New Distribution Facility in Kansas City Region](https://conveyhealthsolutions.com/insights/otc-facility-in-kansas-city/) - FORT LAUDERDALE, FL (BUSINESS WIRE) – July 31, 2018 – Convey Health Solutions (Convey), a leading provider of specialized healthcare technology and services for the government-sponsored markets, today announced the opening of a new distribution facility and creation of more than 40 jobs in Lenexa, Kansas. Convey is experiencing rapid growth in its Over-The-Counter (OTC)
- [Convey Health Solutions Partners with Molina Healthcare to Provide Enhanced Over-the-Counter Benefits to Medicare Members](https://conveyhealthsolutions.com/insights/convey-health-solutions-partners-with-molina-healthcare-to-provide-enhanced-over-the-counter-benefits-to-medicare-members/) - FORT LAUDERDALE, Fla.–(BUSINESS WIRE)–Convey Health Solutions (“Convey“) announced today a partnership with Molina Healthcare to provide Over-the-Counter (OTC) benefits to Molina Healthcare’s members in qualifying Medicare HMO, HMO D-SNP, and MMP plans. The partnership allows Molina to offer enhanced OTC benefits to Medicare plan beneficiaries including increased dollar value allotted to cover OTC items and
- [Convey Health Solutions Acquires Gorman Health Group](https://conveyhealthsolutions.com/insights/convey-health-solutions-partners-gorman-health-group/) - Accelerating Growth and Expanding Offering in Medicare Advantage and Part D Markets Fort Lauderdale, FL, and Washington, DC, (October 16, 2017) – Convey Health Solutions (“Convey”), a leading provider of technology and services for the Medicare Advantage and Part D markets, today announced the acquisition of Gorman Health Group (“GHG”). Gorman Health Group provides market-leading
- [Convey Health Solutions Partners With New Mountain Capital](https://conveyhealthsolutions.com/insights/convey-health-solutions-partners-with-new-mountain-capital/) - Leading provider of benefits and compliance administration solutions to government- sponsored health plans positioned for continued growth and innovation Fort Lauderdale, FL and New York, NY – Convey Health Solutions, Inc., a leading provider of technology solutions for government-sponsored health insurance plans, today announced that it has partnered with New Mountain Capital, LLC, a growth-oriented
- [TPG Partners with Convey Health Solutions](https://conveyhealthsolutions.com/insights/tpg-partners-convey-health-solutions/) - FORT LAUDERDALE, Fla. & SAN FRANCISCO & FORT WORTH, Texas–(BUSINESS WIRE)–TPG Capital, the private equity platform of global alternative asset firm TPG, announced today it has acquired Convey Health Solutions (Convey), a leading provider of technology-enabled and advisory solutions for health plans, from New Mountain Capital (New Mountain). As part of the transaction, Convey management
- [Convey Wins 2020 Excellence in Customer Service Awards for Technology and Outsourcing Services](https://conveyhealthsolutions.com/insights/excellence-in-customer-service-awards-technology-and-outsourcing/) - FORT LAUDERDALE, FL (BUSINESS WIRE) – May 7, 2020 – Convey Health Solutions (Convey), a leading healthcare technology and services company, has been selected as a winner in two categories for the 2020 Excellence in Customer Service Awards presented by Business Intelligence Group. Convey was named ‘Outsource Partner of the Year’ and its Miramar technology
- [Supplemental OTC Benefit Programs Increase MA HMO & PPO Plan Enrollment](https://conveyhealthsolutions.com/insights/otc-medicare-advantage-hmo-ppo-aep-analysis-2/) - FORT LAUDERDALE, FL (BUSINESS WIRE)—Convey Health Solutions (Convey), a leading healthcare technology and services company, today announced completion of a study concluding that plans who offer an over-the-counter (OTC) supplemental benefit in the Medicare Advantage (MA) marketplace grow significantly faster than those plans who do not offer an OTC benefit. Convey utilized its Spotlight technology from Pareto Intelligence
- [Develop Strategic Engagements With Members & Providers Through Rewards & Incentives](https://conveyhealthsolutions.com/webinars/strategic-rewards-incentives/) - Develop Strategic Engagements With Members & Providers Through Rewards & Incentives About This Webinar This Master Medicare Strategy webinar explores rewards and incentives programs. Our panelists share the successes, failures, and processes that helped them improve their programs. We discuss: The current rewards and incentives landscape Regulations that challenge the value of rewards How to
- [Fall Prevention: The Need for a Comprehensive Solution](https://conveyhealthsolutions.com/webinars/fall-prevention/) - Fall Prevention: The Need for a Comprehensive Solution by Convey Team Oct 26, 2022 About This Webinar When considering the various age-related health complications facing older adults, one of the biggest is falling and the numerous negative outcomes that can result from a fall. With falling being one of the largest causes of both fatal
- [How to Successfully Operate a Group Retiree Plan for MA (EGWP)](https://conveyhealthsolutions.com/webinars/how-to-successfully-operate-a-group-retiree-plan-for-ma-egwp/) - How to Successfully Operate a Group Retiree Plan for MA (EGWP) by Convey Team Jan 13, 2021 About This Webinar Group MA, or EGWP (Employer Group Waiver Plans), is often an untapped market within a comprehensive Medicare Advantage (MA) and senior market strategy for many health plans. Group Retiree Coverage growth has increased by over
- [Innovating Your Chronic Care Strategy for MA Beneficiaries](https://conveyhealthsolutions.com/webinars/innovating-your-chronic-care-strategy-for-ma-beneficiaries/) - Innovating Your Chronic Care Strategy for MA Beneficiaries by Convey Team Feb 10, 2021 About This Webinar Having a well-developed chronic care strategy is becoming a must-have when crafting a successful program for your Medicare Advantage beneficiaries. In this webinar we explain ways in which you can be more innovative at a strategic level and
- [Kelley Berlin](https://conveyhealthsolutions.com/kelley-berlin/) - Kelley Berlin is the Senior Vice President & Chief Human Resources Officer of Convey Health Solutions.
- [Katherine Wood](https://conveyhealthsolutions.com/katherine-wood/) - Ms. Wood serves on Convey's board with extensive knowledge of the healthcare industry, service as a board member of private companies, and her leadership and financial expertise.
- [W. Carl Whitmer](https://conveyhealthsolutions.com/w-carl-whitmer/) - Mr. Whitmer serves with extensive knowledge of the healthcare industry, vast executive experience leading healthcare companies, and accounting and financial expertise
- [Matt Powers](https://conveyhealthsolutions.com/matt-powers/) - Matt Powers is the Senior Vice President of Business Development for Convey Health Solutions.
- [Sharad S. Mansukani, M.D., CPE, CMCE](https://conveyhealthsolutions.com/sharad-s-mansukani/) - Dr. Mansukani brings extensive knowledge of the healthcare industry, service as a board member of publicly traded and private companies, and in-depth understanding of the complex U.S. healthcare system.
- [Susana Pichardo](https://conveyhealthsolutions.com/susana-pichardo/) - Susana, as Executive Vice President and Chief Financial Officer, leads Convey with her 26+ years as a finance and accounting professional across five industries including healthcare.
- [Josh Goode](https://conveyhealthsolutions.com/josh-goode/) - Josh Goode is the Executive Vice President and Chief Information Officer of Convey Health Solutions.
- [Giray Akar](https://conveyhealthsolutions.com/giray-akar/) - Giray Akar is the Senior Vice President and Chief Technology Officer of Convey Health Solutions.
- [Jennifer Plasse-Puzey](https://conveyhealthsolutions.com/jennifer-plasse-puzey/) - Jennifer Plasse-Puzey is the Senior Vice President of Operations of Convey Health Solutions.
- [Rick Hess](https://conveyhealthsolutions.com/rick-hess/) - Rick Hess, Convey's SVP & GM, brings 20+ years of leadership in healthcare, life sciences, and the U.S. Navy, with expertise in health plans, pharmacy benefits, and technology solutions.
- [Brandon Solomon](https://conveyhealthsolutions.com/brandon-solomon/) - Brandon first joined Convey Health Solutions in 2018, leading all customer-facing operations and business development for Convey’s subsidiary, Pareto Intelligence. In his current role, he focuses on developing strong partnerships with health plan clients to help them attract, retain, and better manage members with advanced technology and analytic solutions. He is responsible for the strategic
- [Jonathan Starr](https://conveyhealthsolutions.com/jonathan-starr/) - Jonathan is Senior Vice President and General Manager the with over 20 years of experience in healthcare finance and operations.
- [Deborah Johnson](https://conveyhealthsolutions.com/deborah-johnson/) - Deborah, chief compliance officer, oversees the Convey Health Solutions compliance and privacy program to ensure compliance with CMS and other regulatory agencies.
- [John Gorman Announces Resignation from Gorman Health Group, a Convey Health Solutions Company](https://conveyhealthsolutions.com/insights/john-gorman-resignation/) - FORT LAUDERDALE, FL – July 26, 2018 – Convey Health Solutions (Convey) and Gorman Health Group today announced that John Gorman, Founder and Executive Chairman of Gorman Health Group (GHG), intends to resign his positions effective September 15, 2018. “John has dedicated the past 22 years to building Gorman Health Group into the premier partner
- [Convey Health Solutions Appoints Michael DiSimone as CEO](https://conveyhealthsolutions.com/insights/michael-disimone-as-ceo-pr/) - Convey announces Michael DiSimone as CEO, reinforcing its focus on healthcare technology, operational excellence, and health plan performance.
- [The Millennium Alliances’ Healthcare Payers Transformation](https://conveyhealthsolutions.com/insights/millennium-alliance-event/) - June 7-8, 2018 Dove Mountain, AZ North America’s most prominent IT and business leaders from the Healthcare Insurance industry will be gathering on June 7-8, 2018 at The Ritz-Carlton in Arizona to discuss how to adapt to the industry’s customer-centric makeover. Technological advances in Genomics, Personalized Healthcare, Artificial Intelligence (and more!), coupled with consumer demand
- [AHIP Institute & Expo](https://conveyhealthsolutions.com/insights/ahip-institute-expo/) - June 20-22, 2018San Diego, CA AHIP’s conferences focus on the newest approaches, trends and emerging issues. We continuouslyupdate and enhance our programs to make them most relevant in the health care industry. http://www.ahip.org/institute-expo-registration/
- [Medicare Advantage Operational Finance Summit](https://conveyhealthsolutions.com/insights/medicare-advantage-operational-finance-summit/) - July, 2018 As a Medicare Advantage Plan, there are so many challenging operational and accounting issuesimpacting your membership and financial reconciliation. Likewise, CMS continues to update and changeguidance creating the ongoing need to stay ahead of regulatory updates. This Summit will allow attendees to gain implementable solutions to improve your front-end enrollmentand membership operations for
- [From SSN to MBI: Easing the Transition](https://conveyhealthsolutions.com/insights/ssn-mbi/) - The social security number (SSN) is a common form of identification. People are in the habit of providing the nine-digit number as a form of identification in all kinds of situations. Not surprisingly, health plans use the SSN to identify members. This comfortable mainstay is about to vanquish from health plans that work with the
- [Convey Health Solutions Achieves HITRUST CSF® Certification to Manage Risk, Improve Security Posture and Meet Compliance Requirements](https://conveyhealthsolutions.com/insights/convey-health-solutions-achieves-hitrust-csf-certification-to-manage-risk-improve-security-posture-and-meet-compliance-requirements/) - HITRUST CSF Certification validates Convey Health Solutions is committed to meeting key regulations and protecting sensitive information. FORT LAUDERDALE, FL (BUSINESSWIRE)—July, 2018—Convey Health Solutions (Convey), a leading provider of specialized healthcare technology and services for the government-sponsored markets, today announced two of their platforms—Technology Enabled Services (TES) and Business Process Outsourcing and Technology (BPO)—as well
- [Ameerah Murray-Whitaker of Convey Health Solutions Accepted into Forbes Technology Council](https://conveyhealthsolutions.com/insights/ameerah-murray-whitaker-of-convey-health-solutions-accepted-into-forbes-technology-council/) - FORT LAUDERDALE, FL (BUSINESS WIRE)—June 21, 2018—Convey Health Solutions (“Convey”), a leading provider of technology and services for the Medicare markets, today announced that Ameerah Murray-Whitaker, Vice President of Product & Service Delivery (Miramar Products, MA/MAPD), has been selected to join the Forbes Technology Council. Ameerah joins other Forbes Technology Council members to become part
- [HIMSS18 Conference (Healthcare IT)](https://conveyhealthsolutions.com/insights/himss18-conference-healthcare/) - March 5-9, 2018Las Vegas, NV HIMSS18: Where the World Connects for Health. The 2018 HIMSS Annual Conference & Exhibition brings together 45,000+ professionals from around the world for five days of education, innovation and collaboration to help uncover the promise of health information and technology. No other conference brings you the world-class education, cutting-edge products
- [Gorman Health Group Forum](https://conveyhealthsolutions.com/insights/gorman-health-group-forum-18/) - April 25-26, 2018Las Vegas, NV Convey + Gorman A unique healthcare event offering deep discussions on some of the biggest challenges in healthcare. The Gorman Health Group 2018 Forum will provide an intensive cross-functional examination of the state of government healthcare programs to support health plans, providers, and their business partners. You will hear from
- [Medicare Advantage Leadership Innovations](https://conveyhealthsolutions.com/insights/medicare-advantage-leadership-innovations/) - April 10-11, 2018Phoenix, AZ Convey + GormanBreak Down Silos and Promote Cross-functional Coordination & Integration to Achieve Exceptional Plan Performance Medicare Advantage Leadership Innovations brings together our nation’s top-rated MA plans to show you the latest innovations in the critical success areas in Medicare Advantage. http://www.medicareinnov.com/
- [Florida Association of Health Plans Annual Conference](https://conveyhealthsolutions.com/insights/florida-association-health-plans-annual-conference/) - September 5-7, 2018Orlando, FL “To build upon the robust business practices that Florida’s health plans have established, the Florida Association of Health Plans Annual Conference will bring together a distinguished group of business and thought leaders in health care for collaboration on industry best practices, health care regulation and business solutions for improved health outcomes.Non-Member
- [California Association of Health Plans Annual Conference](https://conveyhealthsolutions.com/insights/california-association-health-plans-annual-conference/) - October 22 – 24, 2018 Join over 1000 health care professionals to learn how health plans in California are dealing with change, taking on new responsibilities for the state, implementing laws and regulations, and planning for the future. CAHP and its member plans demonstrated our commitment to improving our health care system bysupporting the passage
- [New York Association of Health Plans Conference](https://conveyhealthsolutions.com/insights/new-york-association-health-plans-conference/) - November 15, 2018Troy, NY Decision 2018: The Intersection of Health Care Policy and Politics The outcome of the November elections will have significant ramifications for New York State and the health care system. This year’s program “Decision 2018: The Intersection of Health Care Policy and Politics” will examine what impact the mid-term elections will have
- [CMS Expects a Stronger Medicare Advantage Market in 2019](https://conveyhealthsolutions.com/insights/cms-expects-stronger-medicare-advantage-market-in-2019/) - Things are looking up for the Medicare Advantage market. According to new data from The Centers for Medicare & Medicaid Services (CMS), 2019 will consist of a significant rise in plan choices in counties across the nation. CMS anticipates that many new providers will enter the market, which subsequently can fuel a continued decrease in
- [Massachusetts Association of Health Plans Annual Conference](https://conveyhealthsolutions.com/insights/massachusetts-association-health-plans-annual-conference/) - November 15, 2018Boston, MA Coverage, Cost and Innovation: Health Care Challenges for 2018 and Beyond The Massachusetts Association of Health Plans represents 17 health plans covering more than 2.6 million Massachusetts residents, MAHP is dedicated to improving health for all in Massachusetts by promoting affordable, safe and coordinated health care. http://www.mahp.com/news-events/annual-conference/
- [Convey Expands Supplemental Benefit Program with Miramar:Benefits](https://conveyhealthsolutions.com/insights/convey-expands-supplemental-benefit-program-miramarbenefits/) - Expansion includes Chronic Condition Program Alignment, Wellness Incentives, PERS and Fall Prevention. FORT LAUDERDALE, FL (BUSINESS WIRE)–Convey Health Solutions (Convey), a leading provider of technology-enabled and advisory solutions for health plans, today announced the launch of Miramar:Benefits. Miramar:Benefits provides an expanded suite of supplemental benefits solutions that includes the market leading over-the-counter (OTC) mail order program as
- [Convey Wins 2020 MedTech Breakthrough Award for Innovative Health Plan Management Platform](https://conveyhealthsolutions.com/insights/outstanding-health-medical-technology-product-company/) - FORT LAUDERDALE, FL (BUSINESS WIRE) – August 18, 2020 – Convey Health Solutions (Convey), a leading healthcare technology and services company, announced that MedTech Breakthrough, an independent market intelligence organization that recognizes the top companies, technologies and products in the global health and medical technology market, has selected Convey’s Miramar platform as the winner of its
- [Convey Health Solutions Named a 2026 USA TODAY Top Workplace](https://conveyhealthsolutions.com/insights/top-workplaces-2026/) - Convey Health Solutions earned the 2026 USA TODAY Top Workplaces award. See how 25 years of culture, values, and people made this recognition possible.
- [Operational Steadiness in Regulated Markets: What Dynamic Agent Management Really Requires](https://conveyhealthsolutions.com/insights/operational-steadiness-agent-management/) - How health plans manage agent onboarding, compliance, and commissions with steadiness across Medicare, Commercial, and Exchange markets. Protect margin, compliance, and commission accuracy.
- [Seamless Union of Purpose-built Technology & Compassionate Customer Service](https://conveyhealthsolutions.com/insights/outsource-partner-technology-of-the-year/) - Business Intelligence Group’s business and industry awards attract submissions from around the world. With such a large field of contenders, the Convey Health Solutions (Convey) team was especially pleased to receive two 2021 Excellence in Customer Service Awards. For the second year in a row, Convey stood out in the technology and outsourcing partner categories. This recognition is
- [Free Your Cash: Stop Losing Money to Flex Card Prefunding](https://conveyhealthsolutions.com/insights/stop-losing-money-to-flex-card-prefunding/) - Most vendors lock up three months of prefunding. Convey requires less than one month—freeing up 68%+ more working capital while still getting you live for the 2026 plan year. Let’s talk about something that keeps Medicare Advantage executives up at night: cash flow. You’re running a health plan in an industry where every dollar matters
- [Convey Health Solutions Recognized by TIME as a World’s Top HealthTech Company​](https://conveyhealthsolutions.com/insights/time-top-healthtech-company-2025/) - Convey Health Solutions announced it has been recognized on the first-ever TIME and Statista list of the “World’s Top HealthTech Companies 2025.” This prestigious recognition honors 400 companies globally that are driving innovation, enhancing accessibility, and contributing to a more effective and sustainable healthcare system. Convey achieved a “very high” overall ranking, placing it among
- [Addressing OTC Utilization Behaviors of MA Beneficiaries during Global Crisis](https://conveyhealthsolutions.com/insights/addressing-otc-utilization-behaviors-during-global-crisis/) - Soon after the World Health Organization declared COVID-19 a global pandemic, Americans became aware that a “new normal” was about to supplant their daily lives. This was a particularly grim reality for those considered most vulnerable if infected by the coronavirus: people age 65 and older, and those with pre-existing medical conditions. Securing health, wellness,
- [Unmatched Expertise & Technology Honored](https://conveyhealthsolutions.com/insights/2021-award-best-overall-medtech-company/) - From among a field of 3,850 nominations submitted from more than 17 countries, Convey Health Solutions (Convey) was recently named Best Overall MedTech Company by the MedTech Breakthrough Awards program. This comes on the heels of last year’s Best Overall Health Administration Software recognition.MedTech Breakthrough Awards annually honor excellence, innovation, and success in a range of health and
- [Are You Managing Your Compliance Program Effectively?](https://conveyhealthsolutions.com/insights/effective-compliance-program-management/) - Taking the time to develop a robust compliance program for your health plan is a given necessity if you wish to operate ethically and with integrity. In addition to avoiding penalties for non-compliance, a truly effective program will help you create a competitive edge, leading to enhanced benefit offerings, improved member retention, and membership growth.
- [Engaging Medicare Advantage Members with Rewards & Incentives Programs](https://conveyhealthsolutions.com/insights/successful-medicare-advantage-rewards-and-incentives/) - Medicare Advantage rewards and incentives programs aren’t new: nearly every plan Convey partners with has one. Historically, they have focused on HEDIS Star measures and predominantly offered gift cards, but it is safe to say that those days are behind us. We recently hosted a webinar that dove into the complexities of rewards and incentives.
- [](https://conveyhealthsolutions.com/uncategorized/7493/) - Member grievances cost Medicare Advantage plans far more than the staff hours spent resolving them. The real damage shows up in Star Rating drops, lost Quality Bonus Payments, and members who quietly leave for competitors—totaling $55 million to $315 million annually for mid-to-large plans. The good news? Plans that invest in member engagement and first-call resolution can turn this compliance burden into a competitive advantage.
- [A Single Thread and the Stories That Shape Convey](https://conveyhealthsolutions.com/insights/convey-womens-history-month/) - This Women's History Month, meet the women of Convey Health Solutions. Their stories are different. Discover the thread that connects them all.
- [Convey Health Solutions Sells HealthScape Advisors](https://conveyhealthsolutions.com/insights/healthscape-advisors-pr/) - Divestiture reflects Convey’s commitment to enhancing and expanding its core technology platform FORT LAUDERDALE, Fla., February 6, 2024 /PRNewswire/ — Convey Health Solutions (Convey), a leading healthcare technology and services company, announced that it has sold its HealthScape Advisors division to Chartis. The divestiture allows Convey to singularly focus on its plan administration, supplemental benefits, and
- [2.9 Million Medicare Advantage Members Are Switching Plans. Are You Ready for Them?](https://conveyhealthsolutions.com/insights/medicare-advantage-forced-disenrollment/) - Nearly 3 million Medicare Advantage members face disenrollment as plans exit markets in 2026. Manage CMS reconciliation risk, SNP complexity, and member transitions without the financial fallout. See how Convey can help.
- [Is Your Medicare Advantage Plan Paying Millions to Run in Place?](https://conveyhealthsolutions.com/insights/medicare-advantage-legacy-system-costs/) - Medicare Advantage plans pay millions maintaining legacy systems. $2M in penalties, $25M in lost Star Rating revenue, 80% IT budgets on upkeep. Calculate what waiting costs your plan.
- [The Hidden Costs of Member Grievances for Medicare Advantage Plans](https://conveyhealthsolutions.com/insights/hidden-costs-member-grievances-medicare-advantage/) - Member grievances can cost Medicare Advantage plans $55M-$315M annually through Star Rating drops, member attrition, and lost Quality Bonus Payments.
- [What Happens When Enrollment, Billing, and Reconciliation Finally Talk to Each Other](https://conveyhealthsolutions.com/insights/enrollment-billing-reconciliation-integration-medicare-advantage/) - Discover how integrated enrollment, billing, and reconciliation systems transform Medicare Advantage operations. Learn why purpose-built integration delivers 90% satisfaction rates and seamless member experiences. Read more.
- [Strengthen Your Culture & Develop Your Competitive Advantage by Investing in Compliance](https://conveyhealthsolutions.com/insights/strengthen-culture-develop-competitive-advantage-invest-in-compliance-2/) - Neglecting the importance of compliance is not sustainable on the part of a health plan or a solution provider. With both public and financial implications in place to protect the integrity of government-sponsored health plans, oversight requirements are an absolute necessity. To prevent exposures that could place them at risk, health plans and their solution providers
- [One Platform, One Partner: The Case for Consolidating Member Management](https://conveyhealthsolutions.com/insights/consolidating-member-management/) - In today’s Medicare Advantage landscape, managing enrollment, billing, reconciliation, and compliance through multiple vendors and legacy systems is no longer sustainable. Fragmented processes slow things down, undermine trust, increase audit exposure, and make it harder to serve your members well. Here’s the truth: member expectations are getting higher every year, but the systems that support
- [The Opportunity for MA Plans to Modernize](https://conveyhealthsolutions.com/insights/the-opportunity-for-ma-plans-to-modernize/) - Medicare Advantage (MA) plans are facing both major opportunities, and significant hurdles. On one side, they are seeing continued growth in Medicare eligibles who have an increased interest in the additional benefits provided by MA[1]. On the other side, chronic diseases are elevating healthcare costs and overall risks for participating health plans. In a market
- [Better Medicare Alliance’s Medicare Advantage Summit 2019](https://conveyhealthsolutions.com/insights/better-medicare-alliance-medicare-advantage-summit-2019/) - July 22-23Washington DC Today, more than one in three Medicare beneficiaries are choosing to receive Medicare benefits through Medicare Advantage. 20 million beneficiaries appreciate the affordability, simplicity, quality care, and enhanced benefits available in Medicare Advantage. The summit is an event that brings together plans, providers, community partners and government to discuss policies and trends
- [AHIP’s National Conferences on Medicare, Medicaid & Dual Eligibles 2019](https://conveyhealthsolutions.com/insights/ahip-national-conference-medicare-medicaid-dual-eligibles-2019/) - September 23 – 26, 2019 Washington, D.C. Get the Insights You Need Dive into deep discussions about priorities, opportunities, and future directions for the Medicare and Medicaid programs. Health care remains at the top of the to-do list for the administration, lawmakers, and health care professionals. Yet as the intensity of debate surrounding health care
- [Michigan Association of Health Plans 34th Annual Summer Conference](https://conveyhealthsolutions.com/insights/michigan-association-of-health-plans-summer-conference-caring-for-quality/) - Caring for Quality Grand Traverse Resort, Acme, MIJuly 17-20, 2019 Join Convey Health Solutions and more than 400 health industry representatives at the 34th Annual Summer Conference! An innovative and fast-paced program is being designed to address the critical issues facing the health care industry. Topics such as the patient experience, population health, technology for
- [2019 Prime Therapeutics Client Summit](https://conveyhealthsolutions.com/insights/2019-prime-therapeutics-client-summit/) - 2019 Prime Client Summit – Stronger Together June 11-12, 2019The IDS CenterMinneapolis, MN June 11-12 at Windows on Minnesota, Convey will be exhibiting on the 50th floor of the IDS Center located in downtown Minneapolis. Connecting with leaders in pharmacy and health care industries that partner with Prime Therapeutics, Convey will be highlighting our supplemental OTC benefit administration and advanced plan administration
- [The 13th Annual RISE Nashville Summit](https://conveyhealthsolutions.com/insights/the-13th-annual-rise-nashville-summit/) - Taking Charge of the Future of Health Care March 17-19, 2019Gaylord Opryland ResortNashville, TN Join us Monday Night for Some Open-Air Networking! Yes, I want to join! As the #1 trusted source for risk adjustment, quality, Stars and beyond, RISE Nashville is the must-attend mega conference for professionals of all levels in the Medicare Advantage and
- [HIMSS19 Champions of Health Unite – Global Conference & Exhibition](https://conveyhealthsolutions.com/insights/himss19-champions-of-health-unite-global-conference-exhibition/) - The Leading Health Information and Technology Conference February 11th – February 15thOrange County Convention CenterOrlando, FL The 2019 HIMSS Global Conference & Exhibition, February 11–15, 2019 in Orlando, is the leading health information and technology conference, bringing together 45,000+ professionals from 90+ countries for the education, innovation and collaboration they need to transform health through
- [Second Annual Medicare Advantage Leadership Innovations](https://conveyhealthsolutions.com/insights/second-annual-medicare-advantage-leadership-innovations/) - Learn Cross-Functional Success Strategies to Reduce Costs and Increase Quality of Care January 28th – January 30thPhoenix Marriott Resort Tempe at The Buttes, AZ Medicare Advantage Leadership Innovations brings together our nation’s top-rated MA plans to show you the latest innovations in the critical success areas in Medicare Advantage. The all new content focuses on
- [Set Your Plan Apart With an OTC Benefit](https://conveyhealthsolutions.com/insights/set-your-plan-apart-with-an-otc-benefit/) - Two of the buzz phrases most frequently heard in the health care community now are “value-based care” and “social determinants of health” (SDOH). Health plan leaders must leverage both to compete. SDOH are particularly important in Medicare and dual-eligible populations, and Medicare Advantage and Part D plans are uniquely positioned to address SDOH through provider
- [Healthcare Payers Transformation Assembly](https://conveyhealthsolutions.com/insights/millennium-alliance-healthcare-payers-transformation/) - Healthcare Payers Transformation Assembly May 22-23, 2019The FairmontDallas, TX Convey is proud to continue to sponsor the assembly, where North America’s most prominent IT and business leaders from the Healthcare Insurance industry will be gathering to discuss how to adapt to the industry’s customer-centric makeover. Delve into the top trends impacting healthcare and health insurance
- [Better Billing, Better Consumer Experience](https://conveyhealthsolutions.com/insights/better-medicare-billing-better-consumer-experience/) - The Medicare Advantage market is heating up – a trend that’s expected to continue, according to a new Kaiser Family Foundation report. In 2019, there will be 417 more MA plans than this year. Fourteen new carriers will offer plans in 26 states, with only five carriers exiting the market. As market competition in MA
- [Why Big Data can be a Game-Changer for Medicare Advantage Plans](https://conveyhealthsolutions.com/insights/why-big-data-can-be-a-game-changer-for-medicare-advantage-plans/) - Big data analytics is a high priority for most payers, but a recent survey found many don’t feel ready to succeed with such initiatives in the current year. Payers shouldn’t wait too much longer, however. The health care sector has been slower than some to harness big data, but it’s beginning to catch on. Health care providers
- [The 3rd Annual CMS Bid Bootcamp](https://conveyhealthsolutions.com/insights/the-3rd-annual-cms-bid-bootcamp/) - Bringing Actuaries and Product Managers Together for an Interactive Exploration of Timelines, Critical Steps and Overall Strategies to Optimize Your CMS Bid January 28th – January 29thFort Lauderdale, FL Join us Monday Night for Happy Hour! Prepare for the CMS Advance Notice in February by joining us at the 3rd Annual CMS Bid Bootcamp and
- [How MA Plans Can Get Ahead of the Curve on Appeals and Grievances](https://conveyhealthsolutions.com/insights/how-ma-plans-can-get-ahead-of-the-curve-on-appeals-and-grievances/) - Many payers are behind the curve on management of appeals and grievances, struggling with outdated technology and procedures. Some are still handling filings manually with spreadsheets. Others use technology designed by software developers without the input of regulatory and health care experts. Antiquated methods lead to needless hours spent compiling data and trying to verify
- [Supercharge Your Automation to Better Address MA Member Needs](https://conveyhealthsolutions.com/insights/supercharge-your-automation-to-better-address-ma-member-needs/) - Medicare Advantage plans recognize that the primary touchpoints with customers are through enrollment and billing. Often treated as discrete operations, the reality is that they are interconnected and also hold many contact points in between. Payers who want to streamline operations while boosting customer satisfaction look for a platform that links enrollment and billing while
- [Is Your Agent Onboarding Process AEP-Ready?](https://conveyhealthsolutions.com/insights/aep-ready-agent-management-process/) - Agents are an extension of your health plan and contribute to your organization’s growth; it is critical to be able to effectively onboard them, and oversee their compliance and performance during the busiest time of the year–Annual Enrollment Period (AEP). Many health plans have burdensome, labor-laden internal processes and/or manage multiple vendors to oversee sales
- [Integrated OTC Benefits: A Prescription for Customer Satisfaction](https://conveyhealthsolutions.com/insights/integrated-otc-benefits-prescription-customer-satisfaction/) - Most over-the-counter products and medications like pain relievers, allergy medications, heartburn drugs and topical antimicrobials were once available only by prescription. In OTC form, these drugs are FDA approved and often equally effective as prescription drugs at a fraction of the cost. Yet their OTC status has long meant these drugs are not covered under
- [Commercial to MA: Supporting Members Through the Health Insurance Lifecycle](https://conveyhealthsolutions.com/insights/supporting-members-through-health-insurance-lifecycle/) - As more Americans age into Medicare, health plans that support the commercial and employer group insurance markets are consistently working to transition those retirees to their government-sponsored Medicare plans during the next phase of their lives. A variety of factors play into this brand-loyalty strategy, and “one important factor is member experience,” said Ameerah Murray-Whitaker,
- [Choosing & Optimizing Your Medicare Advantage Plan’s FDR Partners](https://conveyhealthsolutions.com/insights/choosing-optimizing-your-medicare-advantage-plans-fdr-partners/) - Medicare Advantage Organizations (MAOs) that align themselves with trusted First Tier, Downstream, or Related (FDR) Entities augment essential expertise, skills and industry knowledge of Medicare Advantage (MA). This is particularly beneficial in the critical areas of administrative services and information technology, where limitations on time, money and focus can be debilitating to a plan’s operations.
- [Digital Tools: Low-Income & Senior Population](https://conveyhealthsolutions.com/insights/technology-use-medicare-medicaid-members/) - It is interesting how there are so many digital solutions (and vendors) being offered that are designed to help the senior or low-income population, but few discuss how to get these groups to use or adopt these solutions. In the Medicare markets one of the biggest objectives health plans face are ways to improve the
- [Offshoring Benefits are Bountiful for Health Plans](https://conveyhealthsolutions.com/insights/offshoring-benefits/) - Delivering Efficiencies & Cost Savings [UPDATED 01/2021] A wide variety of industries have discovered the benefits of offshoring, and the healthcare industry is among them. But before your company decides to develop an offshore location for some of its services, it is critical to do the necessary due diligence. Research and planning will help you
- [The Rise of Over-the-Counter (OTC) Programs in Medicare Advantage Plans](https://conveyhealthsolutions.com/insights/rise-of-otc-programs-in-medicare-advantage-plans/) - A 2018 CMS final rule added flexibility to Medicare Advantage (MA) plans in determining supplemental medical and non-medical benefits available to beneficiaries. One such benefit, the Over-The-Counter supplemental benefit, has grown to over 50% market penetration, which outpaces any other newly expanded supplemental benefits. THE SURGE IN OTC COVERAGE “We’re going to have an interesting
- [PBMI 25th Annual National Conference](https://conveyhealthsolutions.com/insights/2020-pbmi-0/) - Educating, Connecting, Sharing Rosen Shingle Creek Hotel – Orlando, FLMarch 2-4, 2020 For two and a half decades, the Pharmacy Benefit Management Institute (PBMI) has been committed to providing an open forum for the exchange of ideas, advance practices, and drive appropriate changes in the pharmacy benefit management landscape. It’s evident that healthcare is changing,
- [Challenge: Forecasting Enrollment in Advance of the Medicare AEP](https://conveyhealthsolutions.com/insights/challenge-ma-aep-forecasting/) - It is that time of year again when health insurers, who offer and sell Medicare Advantage plans and supplements, ramp up operations and sales activities heading into the annual enrollment period (AEP). It is an incredibly stressful time as they look to grow their Medicare Advantage membership. The outcome of how many net new members
- [RISE 4th Annual CMS Bid Bootcamp](https://conveyhealthsolutions.com/insights/2020-rise-bid-bootcamp/) - Critical Steps and Strategies to Optimize Your CMS Bid Westin Fort Lauderdale – Fort Lauderdale, FLJanuary 27-28, 2020 For the 4th year in a row RISE is bringing us the Annual CMS Bid Bootcamp where actuaries and product managers along with other CMS bid stakeholders will come together for an interactive exploration of timelines, critical
- [Encounter Data System (EDS) Submissions for MA Supplemental Benefits](https://conveyhealthsolutions.com/insights/encounter-data-submissions-supplemental-benefits/) - On February 21, 2024, the Center for Medicare and Medicaid Services (CMS) released a notice detailing the requirements for Medicare Advantage (MA) Organizations (MAOs) to submit supplemental benefit encounter data through the Encounter Data Processing System (EDS) beginning with 2024 dates of service. EDS submissions are predominantly managed by risk adjustment programs, either internally or
- [Convey Health Solutions Names Dan Finke as Chief Executive Officer](https://conveyhealthsolutions.com/insights/new-ceo-dan-finke-pr/) - Aetna President to lead Convey into its next phase of growth FORT LAUDERDALE, Fla., January 29, 2024 /PRNewswire/ — Convey Health Solutions (Convey), a leading healthcare technology and services company, announced today that it has appointed healthcare executive Dan Finke as Chief Executive Officer. Finke succeeds Stephen Farrell, who has served the company for more than
- [Developing a Comprehensive Fall Prevention Program For Your Medicare Members](https://conveyhealthsolutions.com/insights/developing-fall-prevention-programs/) - Understanding members and proactively prioritizing fall risk Twenty-eight percent of American seniors over 65 report falling each year.1 Most don’t tell their doctors.For these millions of adults, falls are the number one cause of traumatic brain injury and 95% of hip fractures.2 The CDC estimates that older adults’ falls cost our healthcare system $50 billion
- [Technology & Service Continue to Set us Apart](https://conveyhealthsolutions.com/insights/2022-customer-service-awards-2/) - It’s award season and the accolades keep on coming for our proprietary Miramar technology and top-notch customer service. We’re honored to be recognized by Business Intelligence Group’s Excellence in Customer Service Awards in two categories–Outsource Partner of the Year and Technology of the Year.Third year in a row! Business Intelligence Group describes their awards program as recognizing those
- [Elevate the Member Experience with an Enhanced Supplemental Benefits Program](https://conveyhealthsolutions.com/insights/medicare-supplemental-benefits-platform/) - Look to features to support the plan and member experience like advanced reporting, seamless access to benefits, and comprehensive support services As we move further into 2025, I’m energized by the strategic conversations we’ve continued having with our Medicare Advantage clients. These discussions—reflecting on the recent Annual Enrollment Period (AEP) and looking ahead to the
- [Accolades Keep Coming In for Miramar](https://conveyhealthsolutions.com/insights/accolades-keep-coming-in-for-miramar/) - Recognized with 2022 MedTech Breakthrough Award for Best Overall Health Administration Software Convey’s Miramar platform continues to be honored for streamlining and simplifying the complex and highly regulated Medicare market. MedTech Breakthrough again selected Miramar for its Best Overall Health Administration Software award. The independent market intelligence organization recognizes the top companies, technologies and products in the
- [Convey Health Solutions Partners with GA Foods to Provide Market Leading Healthy Foods Programs](https://conveyhealthsolutions.com/insights/otc-benefits-and-healthy-food-programs/) - FORT LAUDERDALE, Fla., December 2, 2021 /PRNewswire/ — Convey Health Solutions Holdings, Inc. (NYSE: CNVY) (Convey), a leading healthcare technology and services company, and GA Foods, a leading provider of home delivered healthy foods and prepared meals, announced today that they have entered into a strategic partnership agreement to provide Medicare Advantage (MA) members with
- [Deliver Seamless Self-service Experience for Tech-savvy Health Plan Members](https://conveyhealthsolutions.com/insights/self-service-tools-tech-savvy-health-plan-members/) - As the Medicare Advantage (MA) market continues to expand and become more competitive, patient experience and satisfaction are of utmost importance. Health plans want to make sure they are addressing the needs and desires of today’s MA members. Refusing to be left behind in our high-tech world, more and more of today’s MA members have
- [Valuable Insights in Medicare Advantage Member Behaviors](https://conveyhealthsolutions.com/insights/ma-supplemental-benefits-member-behavior-insight/) - Convey’s Deep Data Analytics on Supplemental Benefit Utilization As growth in the Medicare Advantage markets continue, the investment to gain better insight also continues. Special focus is being placed on risk stratification, early intervention programs targeting certain chronic conditions, and product strategies to attract and retain members. Interestingly, product strategies added to attract members may
- [Redefining Healthcare Technology in a Dynamic Environment](https://conveyhealthsolutions.com/insights/redefining-healthcare-technology-in-dynamic-environment/) - Today is an exciting day for Convey Health Solutions as we are now a publicly traded company trading on the New York Stock Exchange under the ticker “CNVY”. I am proud of our team’s focus, discipline, and commitment to our Medicare Advantage (MA) and prescription drug plan (PDP) clients. It is their efforts that have
- [Strengthen Your Supplemental Benefits Portfolio with a Flex Card Solution](https://conveyhealthsolutions.com/insights/supplemental-benefits-flex-card/) - To meet market demands, many health plans are driven to managing multiple supplemental benefits and vendors. This requires an unexpected amount of work to operationalize and support. By consolidating all of your supplemental benefits into a flex wallet program with Convey, your health plan can streamline the disparate solutions and vendors, and bring management and
- [2021 Data Analysis Indicates OTC Benefit Improves Membership](https://conveyhealthsolutions.com/insights/2021-data-analysis-otc-benefit-ma-membership-growth/) - Supplemental benefits have been a valuable differentiator for Medicare Advantage plans since the Centers for Medicare and Medicaid Services (CMS) expanded the scope of coverage to certain non-medical supplemental benefits in 2018. Since then, there has been a continued expansion in the adoption of supplemental benefits, which has required Medicare Advantage Organizations (MAOs) to become
- [Manage Compliance to be CMS Audit-ready](https://conveyhealthsolutions.com/insights/cms-audit-readiness/) - If your health plan struggles to stay current with the evolving Centers for Medicare & Medicaid Services (CMS) regulatory rules, you are not alone. However, recognizing the importance of compliance and developing a compliance culture within your organization are essential to minimizing risk and reducing shortfalls in meeting CMS standards, particularly when faced with a CMS audit.
- [Build a Better Medicare Advantage Enrollment Experience](https://conveyhealthsolutions.com/insights/build-better-medicare-advantage-enrollment-experience/) - Large Medicare Advantage carriers invested a median of $11.25 per member per month in marketing in 2015, and spent a median of $17.44 on account and membership administration, according to a Sherlock Company analysis. With that kind of spending, the last thing a carrier needs is for seniors to become confused and frustrated by the
- [Q&A: Your Top Questions About EGWP](https://conveyhealthsolutions.com/insights/top-ma-egwp-questions/) - As the popularity of Group Medicare Advantage, or Employer Group Waiver Plans (EGWP), continues to build, so too has the interest from health plans considering expanding into this market type. As experts in EGWP Convey along with our affiliate business, HealthScape Advisors understand the complexities of operating these types of plans, and the requirements for EGWP success. Together, we addressed
- [Strengthen Your Culture & Develop Your Competitive Advantage by Investing in Compliance](https://conveyhealthsolutions.com/insights/strengthen-culture-develop-competitive-advantage-invest-in-compliance/) - Neglecting the importance of compliance is not sustainable on the part of a health plan or a solution provider. With both public and financial implications in place to protect the integrity of government-sponsored health plans, oversight requirements are an absolute necessity. To prevent exposures that could place them at risk, health plans and their solution
- [2019 Over-The-Counter Statistics](https://conveyhealthsolutions.com/insights/2019-otc-statistics/) - Why should you consider an over-the-counter supplemental benefit for your Medicare Advantage members? The numbers don’t lie. Offering your members enhanced access to OTC products can reduce financial strain on other healthcare costs: The OTC benefit is steadily rising in popularity, with a significant uptick in 2019: Seniors are shopping for supplemental benefits, and an offering
- [World Congress – Connect19](https://conveyhealthsolutions.com/insights/wc-connect19-stars-quality/) - Advance Health Care Experiences Through Meaningful Connections Renaissance Boston Waterfront Hotel , Boston, MA September 23 – 24, 2019 The CONNECT19 convenes industry experts from hospitals, health plans, and health technology organizations to discuss innovations and best practices to advance health care experiences through the use of digital engagement, consumer-centric design, and transparency measures. CONNECT19
- [Customer Service Awards Highlight Successful Work-at-Home Initiative During Pandemic](https://conveyhealthsolutions.com/insights/gold-stevie-customer-service-award/) - [UPDATED 05/2021] When Convey Health Solutions (Convey) was presented with the 2021 Gold Stevie® Award for Customer Service Management Team of the Year, it was a welcome recognition and culmination of a year in which extraordinary efforts were taken. The accolade was further complemented by a bronze award for Customer Service Team of the Year in The 19th American Business Awards® With the
- [The 13th Annual Medicare Marketing & Sales Summit](https://conveyhealthsolutions.com/insights/2020-rise-mms/) - Medicare Advantage Marketing, Sales, Product Development, and Member Engagement Venetian – Las Vegas, NVFebruary 25-26, 2020 Get practical guidance and techniques that will drive enrollment for your Medicare Advantage line of business. RISE is taking over Vegas yet again to deliver an unmatched conference experience that fosters an open environment to promote the sharing of ideas, challenges,
- [Aligning Supplemental Benefits to the Needs of Diabetic Beneficiaries](https://conveyhealthsolutions.com/insights/aligning-supplemental-benefits-to-diabetic-beneficiaries/) - Today, more than half of all Medicare Advantage (MA) beneficiaries have access to over-the-counter (OTC) health benefits. MA plans have a unique opportunity to offer supplemental benefits to plan members living with chronic illnesses from diabetes to heart disease and more, by tailoring them to an enrollee’s specific needs and conditions. Approximately 80% of older adults have at
- [OTC Benefits Target Chronic Heart Disease to Enhance Outcomes, Reduce Costs](https://conveyhealthsolutions.com/insights/chronic-heart-disease-otc/) - The 2019 CMS guideline changes provided health plans with a new opportunity to enhance over-the counter (OTC) benefits, particularly for beneficiaries with chronic conditions such as heart disease. Through the development of a chronic disease component tailored to members’ needs and conditions, health plans have an ideal opportunity to maximize customer satisfaction while improving outcomes for beneficiaries. At
- [Group vs. Individual Medicare Advantage: What is the Difference?](https://conveyhealthsolutions.com/insights/group-vs-individual-medicare-advantage/) - Understanding the difference between group vs. individual Medicare Advantage (MA) is critical to the decision-making process regarding the types of plans your organization will offer. Group Medicare Advantage, or Employer Group Waiver Plans (EGWP), is one of the most challenging markets within Medicare, igniting interest and questions from health plan executives as this market grows.
- [Implement a Valuable Medicare OTC Card Program](https://conveyhealthsolutions.com/insights/medicare-otc-card-member-services/) - Offer “White Glove” Service with an OTC Benefit Card The supplemental benefits landscape is booming, with OTC benefits as its mainstay. As health plans seek ways to expand and enhance their supplemental benefits, countless Medicare Advantage (MA) members are recognizing the value of their health plan’s OTC benefit as a highly useful and meaningful tool
- [What’s Trending in Employer Group Waiver Plans (EGWP)](https://conveyhealthsolutions.com/insights/egwp-trends/) - Group Medicare Advantage, or Employer Group Waiver Plans (EGWP), is often an untapped market within a comprehensive Medicare Advantage (MA) and senior market strategy for many health plans. Group retiree health insurance markets are experiencing considerable change due predominately to the rapid growth and popularity of Medicare Advantage. Healthcare industry trends show that membership in MA Individual
- [AEP: The “Halloween Horror Nights” of the Healthcare Industry](https://conveyhealthsolutions.com/insights/medicare-annual-enrollment-period-horror-nights/) - Each year, the healthcare industry faces a heart-pounding Annual Enrollment Period (AEP) where eerie complexities can leave you in fear. Join me on a journey, as I unveil my personal “tricks and treats” to better navigate this could-be horror show. In September 2011, my company, Convey Health Solutions, a prominent software and services organization catering
- [OIG Report: HRA Use to Support Risk-Adjusted Payments is Concerning](https://conveyhealthsolutions.com/insights/oig-concerned-mao-use-of-hras/) - Expanded Oversight of MAOs by CMS Recommended The Centers for Medicare & Medicaid Services (CMS) risk-adjusts payments to Medicare Advantage Organizations (MAOs) as a way of leveling the playing field for those MAOs who enroll beneficiaries who require a costlier level of care, thus ensuring these beneficiaries have continued access to the Medicare Advantage (MA)
- [Unprecedented Growth in MA with Supplemental Benefits Expansion](https://conveyhealthsolutions.com/insights/2022-supplemental-benefits/) - When Congress passed the CHRONIC (Creating High-Quality Results and Outcomes Necessary to Improve Chronic) Care Act in February 2018, it presented a significant shift in Medicare policy. Health plans were cautiously optimistic with the promised expansion of health-related supplemental benefits and the introduction of new categories of special supplemental benefits for the chronically ill (SSBCI).
- [California Association of Health Plans – 34th Annual Conference](https://conveyhealthsolutions.com/insights/cal-assoc-of-health-plans-34th-annual-conf/) - JW Marriott Desert Springs, Palm DesertOctober 21-23, 2019 Convey will be in California – let us know if you would like to schedule some time to connect! Connect with convey The California Association of Health Plans’ mission is to serve their members by creating and sustaining an environment that permits them to maintain viability and
- [TAHP’s Texas Covered Health Care Conference + Expo](https://conveyhealthsolutions.com/insights/2019-tx-assoc-of-health-plans-conf-expo/) - Hilton Austin – Austin, TXNovember 11-13th, 2019 Hosted by the Texas Association of Health Plans (TAHP), Texas Covered is the largest event of its kind in Texas and brings together decision-makers from across the health care spectrum—from major health plans, providers and regulators, to legislators, journalists, academics and more. Driven by an agenda tailored to
- [Leverage your OTC Benefit to Improve MA Chronic Disease Outcomes](https://conveyhealthsolutions.com/insights/over-the-counter-chronic-conditions/) - Under recent CMS guideline changes, Medicare Advantage plans have an unprecedented ability to offer supplemental benefits that are not primarily health related to chronically ill enrollees, and to tailor those benefits to an enrollee’s specific needs and condition.This gives plans the opportunity to use their over-the-counter (OTC) benefit in new ways that can have a
- [How Can the OTC Benefit Contribute to Your Strategic Goals?](https://conveyhealthsolutions.com/insights/over-the-counter-benefits-ma-strategic-goals/) - Medicare Advantage plans can’t afford to overlook the importance of over-the-counter benefits. Many have added or are thinking of offering this kind of coverage; in fact, more than half of all MA beneficiaries currently have access to OTC benefits. Unfortunately, these benefits are often offered in a cursory manner, to check a box and ensure the plan
- [Global Pandemic Forces Shift to Work at Home Model](https://conveyhealthsolutions.com/insights/shift-to-work-at-home-model-for-1000-team-members/) - Convey Moves 1,000+ Team Members Home in Record Time Scott TraceySenior Vice President, Information Technology and Information Security, Convey Health Solutions As news broke of the first U.S. case of COVID-19, the Convey Health Solutions (Convey) leadership and crisis management teams met to discuss the potential threat should the novel virus continue to spread. As
- [MA Agent Management for 2021 and Beyond](https://conveyhealthsolutions.com/insights/ma-agent-management-for-2021-and-beyond/) - As payers make strides to embrace digital tools that improve operations and member experience, there is still one area where they continue to struggle—agent management. Often, plans lack the right digital tools to make their agent management easier and more effective. This is a missed opportunity to streamline processes, and to better serve customers. A
- [How to Run a Successful EGWP Program](https://conveyhealthsolutions.com/insights/ma-egwp-success/) - Employer Group Waiver Plan (EGWP) growth has predominantly outpaced that of Individual Medicare Advantage plans over the past 10 years and continues to build in popularity. Many Medicare Advantage (MA) plans struggle with the best way to move forward in an EGWP market. There is uncertainty in what strategies will work to benefit the health
- [2020 HIMSS Global Health Conference & Exhibition](https://conveyhealthsolutions.com/insights/himss20/) - Be The Change Orange County Convention Center, West Building | Orlando, FLMarch 9-13, 2020 HIMSS20 has been cancelled due to the COVID-19 Coronavirus.Read more about the cancellation here. HIMSS is the can’t-miss health information and technology event of the year, where professionals throughout the global health ecosystem connect for the education, innovation and collaboration they need
- [RISE Nashville 2020](https://conveyhealthsolutions.com/insights/the-13th-annual-rise-nashville-summit-0/) - Taking Charge of the Future of Health Care June 28-30, 2020Music City CenterNashville, TN As the #1 trusted source for risk adjustment, quality, Stars, and beyond, RISE Nashville is back for its fourteenth consecutive year as the must-attend mega-conference for professionals of all levels in the Medicare Advantage and ACA market. Join other health plans and physician

## Pages

- [Home](https://conveyhealthsolutions.com/) - Convey’s health plan technology, data analytics, and advisory solutions optimize member enrollment, supplemental benefits, agent management, risk adjustment, and more. Request a demo to transform your operations.
- [Webinars](https://conveyhealthsolutions.com/webinars/) - Webinars Develop Strategic Engagements With Members & Providers Through Rewards & Incentives Convey Team Feb 15, 2023 About This Webinar This Master Medicare Strategy webinar explores rewards and incentives programs. Our panelists share the successes, failures, and Read more Fall Prevention: The Need for a Comprehensive Solution Convey Team Oct 26, 2022 About This Webinar
- [Medicare Supplemental Benefits](https://conveyhealthsolutions.com/medicare-supplemental-benefits/) - Complete Supplemental Benefits Management Solution Optimize your supplemental benefit programs with Convey’s comprehensive management solution. We’re the leading supplemental benefits administrator, delivering expertise, integration, and analytics for maximum performance. Get access to our proven partners, or continue your relationships with existing partners. Request a demo Include us in your RFP Request a demo Craft a
- [Healthcare Compliance Software](https://conveyhealthsolutions.com/healthcare-compliance-software/) - Health Plan Compliance Monitoring Software × ⛶ Streamline critical compliance activities that often rely on manual documentation and distribution. Oversee your health plan’s own compliance with Medicare Advantage and Part D regulations. Watch OMT demo Request a live demo Include us in your RFP Request a demo Who uses OMT Every day, OMT is used
- [Medicare Member Management](https://conveyhealthsolutions.com/medicare-member-management/) - Medicare Member Management for Enrollment, Eligibility, and Billing Manage Medicare enrollment, member data, premium billing, and eligibility workflows in one integrated platform.​ × ⛶ Do you have the necessary holistic approach to your members’ entire journey with your plan? Our built-for-purpose platform is constructed to master complex processes for health insurance enrollment, premium billing, document
- [Medicare Agent Management](https://conveyhealthsolutions.com/medicare-agent-management/) - Medicare Agent & Sales Management Solutions Centralize agent onboarding, oversight, and commissions in one Medicare‑focused platform. × ⛶ Better navigate your sales management process with the automation, efficiency, and compliance of the Miramar:Agent suite of solutions. Improve scalability with advanced agent onboarding, oversight, plan comparison and enrollment portals, telesales services, and commissions management. Watch Miramar:Agent
- [Marketplace Plan Management Solutions](https://conveyhealthsolutions.com/health-insurance-exchange/) - We Serve the Health Insurance Exchange Purpose-built solutions for unique markets Tackle the challenges of government-sponsored plans with Convey’s expertise and understanding of regulatory requirements. With a focus on plans that include the Health Insurance Exchange, we help issuers like you manage the burdens created by the influx of files for analytical or data correction
- [Healthcare Data Analytics](https://conveyhealthsolutions.com/healthcare-data-analytics/) - Leverage our data analytic solutions for member- and plan-level insights and improved healthcare outcomes. Powerful analytics for better decisions.
- [Automate & Outsource Operations](https://conveyhealthsolutions.com/automate-outsource-operations/) - Reduce Administrative burdens. Manual processes. How can you automate or outsource operations to achieve consistent results, improve service, and respond to a changing environment? Focus resources where you need them Leverage automation and outsourcing for improved efficiency, cost, and risk controls. Reducing manual processes offers increased operational flexibility, so staff can be deployed to respond
- [Stars Quality Improvement](https://conveyhealthsolutions.com/stars-quality-improvement/) - Improve Quality and Star Ratings We know that achieving high Star Ratings, maintaining quality, and ensuring compliant risk scores are essential for the success of your health plan. Let us help you accelerate your path forward. Explore a comprehensive set of solutions that will activate members, build loyalty, and give plan leaders data-informed strategies to
- [Member Engagement](https://conveyhealthsolutions.com/member-engagement/) - Engage Greater connections. Greater trust. What does it take to do more than simply sell health insurance products and develop loyal members instead? Guide each step of your members’ journey Appreciating the importance of each touchpoint your members experience goes a long way to increasing engagement. We arm contact center advocates with the information they
- [Commercial Health Plans](https://conveyhealthsolutions.com/commercial-health-plans/) - We Serve Commercial Plans Much like the need to react to regulatory pressures and changes, commercial plans must be ready to react to market pressures and changes in today’s ever-evolving healthcare landscape. Rising costs, regulatory demands, and the push for value-based care require innovative solutions to manage complexity while delivering value to members and stakeholders.
- [Medicare Plans](https://conveyhealthsolutions.com/medicare-plans/) - Your Medicare Plan, Optimized Empowering health plans across the member lifecycle since 2001 Streamline operations, secure compliance, and elevate the member experience. Convey Health Solutions is a leading provider of technology and services for Medicare plans. With a deep understanding of the complexities of the Medicare market, Convey offers a suite of solutions that span
- [Medicare Member Interface](https://conveyhealthsolutions.com/medicare-member-interface/) - Revolutionize Medicare Member Customer Experience We are committed to transforming the way your health plan representatives engage with your members. Our Miramar:Member platform features an elevated member services function designed to streamline the Medicare member experience. Elevate your Medicare member services with dynamic technology This innovative, integrated multi-channel interface is designed to enhance the Medicare
- [Healthcare Risk Adjustment](https://conveyhealthsolutions.com/healthcare-risk-adjustment/) - Risk adjustment solutions to aid in compliant and accurate documentation for every type of government-sponsored healthcare organization. Better understand your risk adjustment performance.
- [Health Plan Premium Integrity](https://conveyhealthsolutions.com/health-plan-premium-integrity/) - Ensure you receive the full premiums you are owed for your Medicare members. Navigate reporting complexities, mitigate compliance risk, and recover capitation underpayments.
- [Medicare Incentive Program](https://conveyhealthsolutions.com/medicare-incentive-program/) - Healthy Rewards & Engagement Healthy activities deserve healthy rewards. Let’s collaborate to achieve a tailored, personalized end-to-end program that drives action—for better quality outcomes and member satisfaction. Request a demo Include us in your RFP Aligned incentives One-size-fits-all engagement strategies limit your plans’ ability to improve health. Connect the right rewards to the right activity
- [Resources](https://conveyhealthsolutions.com/resources/) - Resources Insights Webinars Convey Branding Featured Article Convey Health Solutions Named a 2026 USA TODAY Top Workplace Convey Team Apr 10, 2026 Featured Convey Health Solutions has been named a 2026 USA TODAY Top Workplace, and the timing could not be better. This Read more Latest Insights View all insights Sagility Announces Strategic Alliance with
- [Medicare Member Mail Management](https://conveyhealthsolutions.com/medicare-mail-management/) - Document Processing & Management Streamline document processing and management needs with our comprehensive solution for the government-sponsored health plan market. Integrate critical document management functionality at each stage of the enrollment, premium billing, and grievance processes. Inbound mail and document capture Simplify the complexity of managing high volumes of paper with reduced administrative burden and
- [Medicare Enrollment Software](https://conveyhealthsolutions.com/medicare-enrollment-software/) - Medicare Member Enrollment Technology A comprehensive technology solution for the Medicare member enrollment administration. The enrollment process can be laden with pain points especially when it comes to eligibility verification, enrollment acceptance and validation, and benefit activation and notification. And each step is bound by federal regulations, making compliance paramount. Insert a built-for-Medicare enrollment solution
- [Life at Convey](https://conveyhealthsolutions.com/life-at-convey/) - Join Convey Health Solutions and make an impact. Help improve healthcare access while growing your career in a supportive, flexible, and inclusive workplace.
- [Medicare premium billing](https://conveyhealthsolutions.com/medicare-billing-software/) - Premium Billing Deliver the unparalleled experience your members expect by ensuring clarity and accuracy in premium calculations and management. Added on to the Miramar:Member enrollment function, our solution automates adjustments related to any changes in member coverage. This provides you with a unified approach to managing premiums that guarantees member satisfaction at every interaction. Premium
- [Medicare Grievance Workflows | Miramar:Member](https://conveyhealthsolutions.com/medicare-appeals-grievance-solution/) - Health Plan Grievance Management Streamline compliance processes, ensuring accuracy and timeliness from intake to resolution. Designed for health plans navigating Medicare and Medicare Advantage, we offer a unified solution to manage grievances and appeals intake efficiently. A better way to handle beneficiary grievances Managing grievances is a critical component of engaging with health plan beneficiaries.
- [Anniversary web page (story hub)](https://conveyhealthsolutions.com/25th-anniversary/) - Celebrate 25 years of Convey Health Solutions. Explore our history, milestones, innovations, and the people who have helped shape our journey in healthcare.
- [About Us](https://conveyhealthsolutions.com/about-us/) - About Convey For 25 Years, Convey Has Solved Your Organization's Greatest Challenges Convey Health Solutions is a united family of companies redefining healthcare technology and related services. We understand the changing demands driven by healthcare regulations and market forces, and since 2001, our job has been to anticipate what’s ahead and adapt our solutions. See
- [Strategic Partnership Program Medicare Growth](https://conveyhealthsolutions.com/partnership-program-medicare-growth/) - Explore Convey Health Solutions' Medicare Partnership Program for consultancies, technology vendors, BPaaS providers, and ecosystem partners. Discover partnership models, scalable technology, and growth opportunities.
- [Insights](https://conveyhealthsolutions.com/insights/) - Insights Featured Article Convey Health Solutions Named a 2026 USA TODAY Top Workplace Convey Team Apr 10, 2026 Featured Convey Health Solutions has been named a 2026 USA TODAY Top Workplace, and the timing could not be better. This Read more All Insights Sagility Announces Strategic Alliance with Convey Health Solutions and Simplify Healthcare® to
- [Contact Us](https://conveyhealthsolutions.com/contact-us/) - Contact Us Get in touch Solutions Customer Support Careers & Human Resources (800) 559-9358 Discover our Solutions If you are interested in learning more about how Convey and our family of companies support you in your goals, we are here for you. Contact us today and let's get started! For other inquiries Email: businesssolutions@conveyhs.com Phone:
- [Careers](https://conveyhealthsolutions.com/careers/) - Explore career opportunities at Convey. Join our team of 3,000 employees dedicated to transforming healthcare operations and health plan financial performance.
- [OTC Medicare](https://conveyhealthsolutions.com/otc-medicare/) - Over-the-Counter (OTC) Benefit Convey’s integrated, end-to-end OTC benefit administration solution delivers the OTC solutions your health plan and members appreciate. We’ve been administering our comprehensive OTC benefits program since 2008. Our position as a market-leading provider of supplemental OTC benefit administration services was built on the powerful combination of our proprietary Miramar technology and award-winning
- [Security & Compliance](https://conveyhealthsolutions.com/security-compliance/) - Security & Compliance Committed to Upholding Program Requirements Compliance is at Our Core Convey’s IT security, compliance, and operations teams are aligned to safeguard the security of your membership, data, and organization. We operate as a First Tier, Downstream, and Related (FDR) entity, adhering to applicable state and federal laws and regulations, including client contractual
- [Flex Card Benefits](https://conveyhealthsolutions.com/flex-card-benefits/) - Flex Card Benefits Medicare flex card implementation and management for your membership Deploy a single solution for access to all your supplemental benefits from a leading supplemental benefits administrator. Choose to work with one of Convey’s leading supplemental benefit partners or continue the relationship with your existing partners. Configurable, white-labeled with merchant and item restrictions
- [Health Plan Member Retention](https://conveyhealthsolutions.com/health-plan-member-retention/) - Retain Member satisfaction. Member trust. How do you keep the members you worked so hard to attract and support when it’s time to renew? Prioritize satisfaction The factors that most impact retention—trust and problem resolution.¹ Satisfied Medicare Advantage members are 5x more likely to renew their coverage, and they are more likely to stay with
- [Medicare Food Benefit](https://conveyhealthsolutions.com/medicare-food-benefit/) - Healthy Food Benefits The power of healthy food for your membership A comprehensive healthy food benefit design brings together food procurement and selection oversight, nutritional services, delivery, and customer care. Improve member access to appropriate dietary meal benefits with our program management and integrated solution. Healthy food options fit members’ needs Medicare Advantage members can
- [Medicare Member Payment Reconciliation](https://conveyhealthsolutions.com/medicare-member-payment-reconciliation/) - Membership & Financial Data Reconciliation Synchronize Data, Maximize Revenue Optimize your management and reconciliation of Medicare membership and Health Insurance Exchange financial data. In the complex landscape of healthcare, reconciling Medicare member data and Health Insurance Exchange payments can be a daunting task. Manual processes, data discrepancies, and ever-changing regulations can strain resources and impact
- [Attract Health Plan Members](https://conveyhealthsolutions.com/attract-health-plan-members/) - Attract New members. Valued members. What draws Medicare Advantage members to your plan and not your competitors’? Tailored benefit design Grab attention with the exceptional supplemental and extra benefits your members want. Flex-benefit card puts control in members' hands Members take charge of all their benefits with one card. Our web platform, mobile app, and
- [Terms & Conditions](https://conveyhealthsolutions.com/terms/) - Terms & Conditions Your access to, browsing of and use of this website (the “Site”) is subject to the following terms and conditions (the “Terms and Conditions”) as well as all applicable laws. Please read the Terms and Conditions carefully. By accessing, browsing or using the Site, you accept and acknowledge your agreement with and
- [Leadership Main Page](https://conveyhealthsolutions.com/leadership/) - Leadership Built With Years of Deep Industry Experience Michael DiSimone Chief Executive Officer Susana Pichardo Executive Vice President & Chief Financial Officer Josh Goode Executive Vice President & Chief Information Officer Giray Akar Senior Vice President & Chief Technology Officer Jonathan Starr Senior Vice President & General Manager Rick Hess Senior Vice President & General
- [Privacy Policy](https://conveyhealthsolutions.com/privacy/) - Privacy Policy For over a decade, Convey Health Solutions (“Convey”) has been an industry leader in fully compliant management of large-scale end-to-end health insurance processes. As experts in health insurance administration support, Convey values your privacy and is committed to full transparency with respect to your rights as it concerns how we care for and
- [Health Plan Administration Management](https://conveyhealthsolutions.com/health-plan-administration-management/) - Manage Better enrollment. Better experience. How do you master the myriad systems you need to manage the members it took considerable resources to attract? Streamline enrollment Trust a solution designed for the Medicare market from intake and verification to reporting. Convey’s Miramar:Member platform isn’t retrofitted for Medicare. It was built for it and evolved to
- [Recruitment Fraud](https://conveyhealthsolutions.com/recruitment-fraud/) - Recruitment Fraud Disclaimer What is Recruitment Fraud? Recruitment fraud is a growing national trend where fraudsters attempt to use an employer’s name to trick job seekers with fake employment opportunities. This type of fraud is typically carried out through fake job postings, fake websites, or email accounts claiming to be from the employer. The goal

## Authors

- [Brandon Solomon](https://conveyhealthsolutions.com/author_profile/brandon-solomon/) - Read the latest industry insights, strategic analysis, and expert advice from Brandon Solomon, Convey SVP & Pareto Intelligence General Manager.
- [Shannon Rose](https://conveyhealthsolutions.com/author_profile/shannon-rose/) - Explore data-driven industry insights, deep dives, and expert commentary from Shannon Rose, Convey's lead insights contributor and editor.
- [Marcello Figallo](https://conveyhealthsolutions.com/author_profile/marcello-figallo/) - Read the latest industry insights, strategic analysis, and expert advice from Marcello Figallo, Convey's Senior Director of Product Strategy & Consumer Experience.
- [Isabella Wellborn](https://conveyhealthsolutions.com/author_profile/isabella-wellborn/) - Read the latest industry insights, strategic analysis, and expert advice from Isabella Wellborn, a client success manager at Convey.
- [Brittaney Santillo](https://conveyhealthsolutions.com/author_profile/brittaney-santillo/) - Read the latest industry insights, strategic analysis, and expert advice from Brittaney Santillo, a client success manager at Convey.
- [Scott Tracey](https://conveyhealthsolutions.com/author_profile/scott-tracey/) - Access historical industry insights, foundational analysis, and expert perspectives from Scott Tracey, Convey's former chief information & information security officer and 14-year company veteran.
- [Tom Pelegrin](https://conveyhealthsolutions.com/author_profile/tom-pelegrin/) - Access historical industry insights, foundational analysis, and expert perspectives from Tom Pelegrin, Convey's former chief revenue officer.
- [Stephanie Jones](https://conveyhealthsolutions.com/author_profile/stephanie-jones/) - Access historical industry insights, foundational analysis, and expert perspectives from Stephanie Jones, Convey's former chief operations officer and 19-year company veteran.
- [HealthScape Advisors](https://conveyhealthsolutions.com/author_profile/healthscape-advisors/) - Access historical industry insights, foundational analysis, and expert perspectives from HealthScape Advisors for Convey Health Solutions.
- [Stephen Farrell](https://conveyhealthsolutions.com/author_profile/stephen-farrell/) - Access historical industry insights, foundational analysis, and expert perspectives from Stephen Farrell, Convey's former CEO and 13-year company veteran.
- [Keith Carrington](https://conveyhealthsolutions.com/author_profile/keith-carrington/)

## Categories

- [Uncategorized](https://conveyhealthsolutions.com/category/uncategorized/)
- [Leadership](https://conveyhealthsolutions.com/category/leadership/)
- [Board of Directors](https://conveyhealthsolutions.com/category/board-of-directors/)
- [Insights](https://conveyhealthsolutions.com/category/insights/)
- [Webinars](https://conveyhealthsolutions.com/category/webinars/)

## Tags

- [Chief Executive Officer](https://conveyhealthsolutions.com/tag/chief-executive-officer/)
- [Senior Vice President & General Manager](https://conveyhealthsolutions.com/tag/senior-vice-president-general-manager/)
- [Senior Vice President of Operations](https://conveyhealthsolutions.com/tag/senior-vice-president-of-operations/)
- [Senior Vice President, Business Development](https://conveyhealthsolutions.com/tag/senior-vice-president-business-development/)
- [Chairman – Board of Directors](https://conveyhealthsolutions.com/tag/chairman-board-of-directors/)
- [Board of Directors](https://conveyhealthsolutions.com/tag/board-of-directors/)
- [Featured](https://conveyhealthsolutions.com/tag/featured/)
- [Executive Vice President & Chief Financial Officer](https://conveyhealthsolutions.com/tag/executive-vice-president-chief-financial-officer/)
- [Senior Vice President & Chief Technology Officer](https://conveyhealthsolutions.com/tag/senior-vice-president-chief-technology-officer/)
- [Senior Vice President & General Manager, Pareto Intelligence](https://conveyhealthsolutions.com/tag/senior-vice-president-general-manager-pareto-intelligence/)
- [Senior Vice President & Chief Human Resources Officer](https://conveyhealthsolutions.com/tag/senior-vice-president-chief-human-resources-officer/)
- [Vice President & Chief Compliance Officer](https://conveyhealthsolutions.com/tag/vice-president-chief-compliance-officer/)
- [Executive Vice President & Chief Information Officer](https://conveyhealthsolutions.com/tag/executive-vice-president-chief-information-officer/)