In a survey of 22 health systems by Lumeris and The Health Management Academy, leading executives indicate that value-based arrangements are a strategic priority. Providers are pursuing a variety of programs that align with their strategy to take on financial risk, such as accountable care organizations (ACOs) and provider sponsored plans. However, respondents also share the (…)
A new report from research firm IDC Health Insights examines the information technology needs of accountable care organizations beyond an electronic health records system.
Prestigious honor goes to industry leader for being top-performing full-service firm enabling value-based care ST. LOUIS — February 1, 2018 – Lumeris, the industry leader in value-based care solutions, announced today that for the third year in a row, KLAS Research has named the company as the top-rated full-service, value-based-care managed services firm in the 2018 (…)
The Value of Integrating EMR and Claims/Cost Data in the Transition to Population Health Management
It might be a move in the right direction, or it could be a significant change in how the physician fee schedule encourages certain types of care—we won’t know until later—but right now it’s encouraging that CMS is considering paying primary care physicians for chronic care management services without an in-person visit, and also for telehealth services. “I think primary care physicians are going to see a tsunami of patients wanting care and newly insured in 2014, and this is one of the easier ways to expand capacity,” said Tom Doerr, MD. “You don’t have to take on the hiring of a new midlevel clinician. There is a lot less stress involved with just sending an email and getting reimbursed for it.”
In my role at Lumeris I often get asked by our clients, “What does care management really mean?” For me, having spent decades practicing geriatric medicine and teaching the principles of post-acute care coordination at a private research university and medical center, care management can be defined, most completely, as better care at lower cost for people with multiple health and social needs.
Provider-sponsored Medicare Advantage plans provide an excellent opportunity for health systems to manage the premium dollar through a value-based contract. However, for every example of a successful provider-led plan, there are many more cautionary tales of providers struggling operationally to obtain positive outcomes. As seen in this infographic: Not even half of provider-sponsored MA plans (…)
Medicare Advantage continues to be a popular choice for seniors, with enrollment outpacing overall Medicare growth. Moreover, seniors are gravitating toward higher quality plans, as seen in this infographic depicting the enrollment distribution by plan Star Rating. More than 70 percent of Medicare Advantage Prescription Drug plan beneficiaries are enrolled in plans with four or (…)
CMS released a long-awaited checkpoint status on its Pioneer ACO program. Of the 32 entities enrolled in the program, according to CMS…
ST. LOUIS — Lumeris, the industry leader in value-based care solutions, today announced that the Centers of Medicare and Medicaid Services (CMS) has awarded long-time Lumeris client Essence Healthcare 4.5 out of 5 stars in its annual quality assessment of Medicare Advantage plans. The St. Louis-based Essence Healthcare has earned a 4.5 star rating or better for seven (…)