Category: Thought Leadership

How to Design and Implement a Health Equity Plan in ACO REACH: Part 2 of 2

August 1, 2022 | By

Erica Everhart Senior Specialist for APMs, CareJourney Sally Engelman Director, Strategic Partnerships, Lumeris Take our ACO reach readiness quiz The statements contained in this analysis are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this (…)


Leveraging Value-Based Care to Diversify Health System Revenue and Improve Financial Performance

July 28, 2022 | By and

Alicia Finan Business Development Market Lead  Nico Neugebauer Business Development Director   As we enter the third year of the COVID-19 pandemic, health systems across the country continue to face tremendous external pressures on profitability. In the last year alone, we have seen hospital margins decrease by 76%[1] as patients arrive at facilities sicker and (…)


Thinking of Starting a Medicare Advantage Plan (or Integrating a New Collaborative Plan into Your Senior Portfolio)? 2024 Starts Now.

July 26, 2022 | By and

Dan Juberg Vice President, Head of West Markets  Matt Farnum Vice President, Strategy & New Markets    Collaborative Medicare Advantage payer partnerships and provider-sponsored senior health plans are gaining traction across the country as a critical strategy for profitable, value-based care. However, many organizations underestimate the necessary lead time and effort required to move from (…)


Strategic Implications of Health Equity in ACO REACH: Part 1 of 2

July 11, 2022 | By

Rick Goddard Vice President, Commercialization & Strategy, Lumeris Aneesh Chopra President, CareJourney Take our ACO reach readiness quiz The statements contained in this analysis are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in (…)


CMS Update: Pathways for Specialty Care Coordination and Integration in Population-based Models

June 24, 2022 | By

The Centers for Medicare and Medicaid (CMS) recently released a blog on specialty care and its alignment with total cost of care models. While we have seen the Centers for Medicare and Medicaid Innovation (CMMI) experiment with specialty-based models via the Bundled Payment programs and have seen cost reductions and quality improvements in certain episodes, (…)


Our Accelerated Journey to Improving the Health of our Community

June 22, 2022 | By

Antonio Rios, MD Chief of Population Health, Northeast Georgia Health System   “When you can demonstrate that your diabetic patient population has improved overall, when screening every diabetic patient for their eye exam allows you to perform early interventions for folks who could otherwise have experienced significant complications, or when you’ve increased the percentage of (…)


Best Practices in Stakeholder Alignment, Communication & Network Design

June 9, 2022 | By

Joseph Satorius Senior Vice President, ACO Programs & Strategic Operations, Lumeris The statements contained in this analysis are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document. As the CMMI (Center for (…)


Introducing ACO REACH: The Evolution of Direct Contracting

March 11, 2022 | By and

Joseph Satorius Senior Vice President, ACO Programs & Strategic Operations, Lumeris Rick Goddard Vice President, Commercialization & Strategy, Lumeris Take our ACO reach readiness quiz On February 24, CMS announced the continuation of the Direct Contracting (DC) Program under a rebranded name called the ACO REACH Model* along with several important programmatic updates. The updates (…)


Provider Networks and Risk: Network Curation via Direct Contracting

December 15, 2021 | By and

For over a decade now, the Centers for Medicare and Medicaid Innovations (CMMI) has advanced their risk-based Medicare programs to delegate more financial accountability to providers. The ability to curate a network to fit the financial parameters of this program make the evaluation of this opportunity different than anything we have seen in the past. (…)


CMS Innovation Center Strategic Refresh Emphasizes Value-based Payment Models and Health Equity

October 24, 2021 | By and

John Fryer, SVP and Head of Market and Rick Goddard, Sr. Director, Market Strategy Last week the Center for Medicare and Medicaid Innovation (CMMI) introduced their strategic refresh “Putting All Patients at the Center of Care” to support broader, more equitable, and outcome-based healthcare delivery transformation while streamlining current and future payment models.    Since its inception in 2010 as a (…)


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