Medicare for care organizations
How Medicare works, and how health systems keep up
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What Medicare is and why it shapes how health systems deliver care
Medicare is the federal health insurance program for people 65 and older, and for certain people with disabilities. It shapes how hospitals document care, submit claims, report quality, and run day-to-day clinical workflows. SD Global does not sell Medicare plans. We help care organizations handle the technology and operations behind it.
Original Medicare coverage
Medicare Advantage plans
How Medicare works
The core parts of Medicare every health system should understand
Parts A and B
Part A covers inpatient hospital care, skilled nursing, hospice, and some home health. Part B covers outpatient care, physician services, preventive services, and durable medical equipment.
Medicare Advantage
Also called Part C, these plans come from private insurers approved by Medicare. They bundle Part A and Part B and often add vision, dental, or prescription coverage.
Part D and Medigap
Part D helps cover prescription drugs. Medigap policies help pay costs Original Medicare does not. Together they fill gaps for beneficiaries and shape how providers coordinate benefits.
How we support Medicare operations
Where SD Global helps health systems navigate Medicare complexity
Documentation and claims workflows
We help configure EHR workflows for accurate Medicare documentation, coding support, and cleaner claims submission across clinical teams.
Quality, Stars, and risk adjustment
We help connect clinical data to quality reporting, Stars performance tracking, and risk adjustment for Medicare Advantage and value-based programs.
Provider challenges
The Medicare pressures that hit clinical and IT teams hardest
Claims and revenue integrity
Incomplete documentation and fragmented workflows can lead to denials, delayed reimbursement, and costly rework for Medicare claims.
Quality and reporting burden
Measure capture, Stars performance, and reporting deadlines put heavy pressure on clinical and analytics teams without the right systems behind them.
Interoperability and compliance
Medicare programs rely on clean data exchange, CMS-aligned processes, and HIPAA-safe infrastructure that many organizations still struggle to maintain.
Who this is for
Supporting organizations that care for Medicare populations every day
Hospital systems
Physician groups
Post-acute care
Health plans
