Essence Healthcare, Lumeris’ pioneer client, has just received an extraordinary rating from the Centers for Medicare and Medicaid Services (CMS), 5-Stars, for the quality of services it delivers to its Medicare Advantage (MA) members, placing it in the 98th percentile of all MA plans.
At a conference with leading health system CFOs last week, participants shared valuable ideas, successes and struggles with their peers. Open discussions and panels provided thought-provoking insights for CFOs navigating (…)
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 (…)
I travel a lot. In fact, I fly so much that the airlines I frequent actually treat me fairly well. In my role I get to engage with provider organizations (…)
This Perspectives series looks at the challenges provider-sponsored health plans (PSHPs) can face. Part 1, Why Provider-Sponsored Health Plans Fail, examined the market dynamics motivating provider organizations to launch health (…)
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 (…)
Health system executives understand the move to value-based care is here. But accepting that reality doesn’t answer their questions about when and how to transition from a business model based (…)
For years, vendors in the population health management space have been pushing technology as the solution to the inefficiency of the healthcare system. Many people believed that if you could gather the data and integrate it together, you could improve quality, cut costs and make everyone happy. But, we are now at a point where we see that technology alone is not the answer.
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 (…)
Since our formation more than a decade ago by a group of local doctors, Essence Healthcare has worked side by side with doctors to provide comprehensive and affordable health insurance to over 40,000 people with Medicare in Missouri and southern Illinois. We are honored to receive the 4.5 star rating for a fourth year in a row.