Providers moving toward a value-based care system are finding success in engaging patients by applying the best-practice experience from primary care physicians (PCPs), as summarized in Lumeris’ Accountable Primary CareSM Model, also known as the Nine C’s®.
Category: Thought Leadership
As consumers begin to accept accountability for their health, payers and providers have the opportunity to build trust and improve their experience and engagement. Equipped with new tools and information to compare costs and coordinate care, accountable physicians have financial incentives to deliver better quality care and lower costs.
Client: Essence Healthcare – Lumeris used the Collaborative Payer Model between payers and providers. A mentorship program to align physician behaviors around accountability to achieve the Triple Aim Plus One was also incorporated to achieve the desired outcomes. The Accountable Delivery System Platform (ADSP)® was deployed to enable the financial and clinical management of the defined population, resulting in nearly 65% MCR (2013 before physician compensation distribution), a 30% reduction in costs and 40% reduction in readmission rate compared to an unmanaged population.
Providers can become true managers of quality—and earn bonuses as part of value-based contracts—by making full use of data to close gaps in care as well as data transparency to benchmark their performance against their provider group and national peers. At Lumeris, our powerful technology solutions provide market differentiation for health systems and payers, especially in equipping their network of providers with the ability to stratify patients and populations for improved quality performance.
How does an investment in quality deliver value for health systems, payers, providers, and patients? From government-led ACOs to commercial contracts, successful quality management begins with strategic assessments that pinpoint where to focus improvement efforts. At Lumeris, our proven approach optimizes quality metrics in any value-based care model.
Delivering high-quality care is essential to succeeding in today’s evolving market. Well-chosen quality metrics and effective incentives in value-based contracts can lead to healthier populations by generating better clinical, operational and patient outcomes. Lumeris simplifies quality management for health systems, payers and providers.
Photo: Lumeris Presents “Collaborative Payer Innovations Driving ROI in Value-Based Care” at HIMSS14
Deborah W. Robin, MD, MHCM, medical director of Lumeris, and Dr. Edward Scanlan, medical director of Network Health, presented an educational session at the HIMSS14 Annual Conference in Orlando, Fla. on February 26. The session explored how collaborative payers are engaging and empowering providers to meet quality, cost and utilization metrics in their value-based contracts and (…)