Category: Industry News

Peeling Back the Medicare Advantage Onion

April 24, 2019 | By

According to CMS, a record 22.4 million seniors will be covered by a Medicare Advantage (MA) plan in 2019, up 11.5 percent from 2018. One reason that MA plans are increasingly popular among consumers is because coverage typically includes a richer choice of benefits than traditional Medicare, often providing lower premiums and out-of-pocket costs. Read (…)


Hospitals See Improvement in Value Contracting with Commercial Plans

March 29, 2019 | By

Hospitals continue to have more difficulty establishing value-based payment (VBP) arrangements with commercial health plans compared with government payers Commercial-plan VBP caution may be thawing, especially around Medicare Advantage Hospitals are increasingly considering downside risk Hospitals continue to have more difficulty establishing value-based contracts with commercial health plans than with government payers, but that may (…)


How a Hospital or Health System Can Assess the Risk of Moving to Value-Based Payment

March 29, 2019 | By , , and

Health systems considering a strategic move away from the traditional fee-for-service (FFS) payment model to value-based payment approach can benefit from modeling the risks and likely effects of such a move. Health systems across the country are struggling to maintain their overall profitability and operating margins. Organization leaders realize they must take a hard look (…)


How Medicare Advantage steers the Silver Tsunami into coordinated, value-based care

March 26, 2019 | By

CMS and other health insurers are using the program to deliver innovative and unique value to customers, both in terms of cost and quality. Today’s Medicare Advantage plans are flourishing and the Silver Tsunami is among the reasons. Click here to read the full article.


One Industry Expert Looks at the Challenges to Moving Analytics Forward Under Value-Based Payment

March 25, 2019 | By

Among the complexities involved in moving forward on data analytics for value-based payments is the need to push ahead on payment reform, says Lumeris’s Debbie Zimmerman, M.D. The journey into leveraging data analytics for success in value-based care delivery and payment arrangements is turning out to be a long one, industry experts, and those in (…)


HIMSS Conversations Where the Passion, the Personal, and Technology Meet

March 8, 2019 | By

Listen to Lumeris Chief Marketing Officer, Matt Cox, share his insights about the importance of healthcare’s move toward value and our need to align around outcomes.  To listen to the interview, click here.


29 HIMSS19 insights, innovations and disruptions

March 8, 2019 | By

Lumeris Chief Marketing Officer, Matt Cox, provides his reflections on HIMSS 2019 along with other healthcare executives. Matt Cox. Chief Marketing Officer, Lumeris: After attending HIMSS19, which was my 15th year at the conference, one thing is clearer than ever before: Change in healthcare requires far more than just technology—especially for a major industry transformation like the (…)


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 (…)


Health system executives expect 25% of care delivery payments to be value-based in 2019

February 21, 2019 | By

Health system executives predict the shift to value-based payment models will continue to increase this year, according to a survey conducted by The Health Management Academy for Lumeris. The recently released survey was conducted in May and August among 25 healthcare system executives representing organizations that own or operate 280 hospitals. To read the full (…)


Seniors more likely to switch Medicare Advantage plans in 2019, survey shows

January 16, 2019 | By

Today’s seniors are increasingly tech savvy, expect more from Medicare plans and in 2019 are more likely to switch their Medicare Advantage plans, finds a new survey from Welltok. With more than 60 million Americans projected to be covered by Medicare by 2020, it is critical for plans to understand and meet members’ individual needs (…)


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