Author: Lumeris

Lumeris Awarded NCQA Accreditation for Case Management and Utilization Management

July 23, 2019 | By

Lumeris also fully Certified by NCQA for 11 out of 11 verification services   ST. LOUIS, MO — JULY 23, 2019 – Lumeris, an industry leader in value-based care, today announced that the National Committee for Quality Assurance (NCQA) Review Oversight Committee has awarded the company Accreditation status for Case Management and Utilization Management. In (…)


Aligning Physicians for Value-based Care

May 9, 2019 | By

Physician alignment is essential as health systems move toward value-based models. Surveyed leading health systems point to several strategies they use to work with their providers as they change the way care is delivered, such as developing clinically integrated networks (CINs), supporting employee culture, developing communication and governance processes, and incorporating contract metrics around quality (…)


The Financial Impact of Value-Based Contracts: What’s at Stake for Health Systems

April 23, 2019 | By

As health systems evaluate their ability to transition from fee-for-service medicine toward value-based care, they must understand the financial impact of their strategy. In our recent analysis, The Impact of Transitioning to Value on the Financials of a Health System, we investigate different strategic scenarios that a health system could pursue, ranging from keeping the (…)


Lumeris and The Health Management Academy Q1 2019 Surveys

April 19, 2019 | By

Lumeris and The Health Management Academy (The Academy) are surveying leading health systems to understand strategic factors impacting their move to value. Each quarter, we bring data and insights covering our findings across key areas. Fill in the form to read the strategic survey reports: Defining risk: Determine how health system executives define risk in their (…)


The Impact on the Financials of a Health System Transitioning to Value

April 19, 2019 | By

Health systems across the country are facing tremendous financial pressures—from maintaining operating margins and profitability, to facing a shifting payer mix and stagnating reimbursement rates. These trends are creating challenges for health systems steeped in fee-for-service (FFS) care delivery. As a result, many systems are taking a hard look at their existing business model to (…)


The transition to value-based care continues to accelerate

March 28, 2019 | By

Market and regulatory pressures continue to drive health systems toward value-based payment. In a survey of leading health systems, half of executives state that the shift to value-based care is happening either quickly or very quickly at their organization. Moreover, respondents indicate that 23% of total care delivery in the last quarter of 2018 was (…)


Lumeris and Stanford Health Care to Collaborate

March 19, 2019 | By

Stanford Medicare Advantage plan seeks sustainable growth and continued innovations to serve seniors in collaboration with Lumeris. ST. LOUIS, MO — March 19, 2019 — Lumeris, an industry leader in value-based care, and Stanford Health Care, one of the nation’s leading academic medical centers, have agreed in principle to a long-term collaboration for the further development (…)


Critical Drivers for Success in Value-based Care

March 1, 2019 | By

Health systems across the country are accelerating their move toward value-based care. Whether they are looking to manage value-based contracts with payers in the market or launch their own health plan, providers are realizing that much of the difficulty in transformation lies in the “how”. Operationalizing value-based models successfully can be challenging for organizations new (…)


Provider partnerships continue to grow

February 25, 2019 | By

As health systems look to transform care delivery and business models in the wake of value-based care, provider partnerships are expanding. In particular, surveyed health system leaders are leveraging the expertise of external partners to implement and scale solutions more rapidly than building capabilities from scratch. To learn more about what leading health systems are (…)


BayCare Teams up with Cerner, Lumeris and Salesforce to Improve Health of Senior Population

February 13, 2019 | By

Kansas City, Mo. — February 13, 2019 — BayCare Health System, a leading not-for-profit health care system in central Florida, is leveraging advanced technologies and services from Cerner, Lumeris and Salesforce to better manage its populations. BayCare’s overall strategy to increase access to care and improve the health status of its patients is supported by (…)


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