by Matt Nolan, Vice President, Lumeris This Perspectives series looks at why provider sponsored health plans (PSHPs) fail. This post, Part 1, discusses the market dynamics that are forcing organizations (…)
As providers assume greater risk from payers, they are requesting accountability from consumers. But, how do providers engage and empower consumers to make educated health choices and become partners in their own health care? In this point of view, Lumeris offers five, interrelated strategies, based on 10 years of value-based care experience, to help guide accountable providers to successfully engage patients for better clinical and financial outcomes.
Effective provider engagement in value-based care is an ongoing operation that requires a comprehensive approach and proven methodologies. In the first post we illustrated the different activities to implement for (…)
We continue to examine the success factors for supporting providers during their transition to value-based care. In the first segment we looked at providers just starting on their journey and (…)
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.
One of the biggest challenges for health systems transitioning to value-based care contracts is figuring out how to engage physicians in the process. Physician buy-in is critical for value-based care (…)
What Leading Consultants are Talking About: Takeaways from the Lumeris Value-Based Care Leadership Summit Earlier this month in Dallas, Lumeris had the privilege of hosting 30 of the industry’s top (…)
This three-part blog post series highlights why Medicare accountable care organization (ACO) participants should evaluate Medicare Advantage as a longer-term strategy. In the first part, we covered the proposed “Pathways (…)
Trying to Accelerate the Move to Value? The Limitations of Medicare ACOs Ben Kline, Vice President Strategic Partnerships This three-part blog series covers why Medicare accountable care organization (ACO) participants (…)
The accelerating push toward value-based healthcare is driving market disruption: hospital mergers and acquisitions, payers purchasing providers, and retail giants with health clinics proposing to merge with or buy insurance (…)