Richard Jones Discusses Essence Healthcare’s 5 Star Rating
Download the whitepaper The march toward value-based care delivery and financing will continue despite deep industry structural inertia, business self-preservation motives, and the shift in national politics. As we head toward 20 percent of US gross domestic product (GDP) being spent on healthcare, economic forces and federal budget math will demand the long-term transition to (…)
In just a few words, Lumeris CEO Mike Long explains the Lumeris Model.
Provider Sponsored Plans and Medicare Advantage are gaining traction as a critical strategy for profitable, value-based care. However, many underestimate the necessary lead time and effort required to move from consideration to activation. Planning for a 2019 launch needs to begin now starting with a detailed market and organizational feasibility study for standing up a (…)
Atlanta healthcare executives discuss fee-for-value Ross Armstrong Senior Vice President and Head of Market, Lumeris The number of healthcare organizations transitioning from fee-for-service to value-based care is rapidly increasing in the United States. This growth and evolution has changed the healthcare landscape and strategy for years to come. I recently had the opportunity to lead (…)
If you’re thinking of starting a new Medicare Advantage Prescription Drug (MAPD) plan in 2019, then the time to start planning is now. Applications to CMS for 2019 will be due in February of 2018. In order to be successful in the application process you’ll need to obtain an insurance license from your state’s Department (…)
Though MACRA and regulatory forces are encouraging providers to adopt value-based care delivery, many remain on the sidelines. Many are hesitant to begin this transition to managing risk; others simply ignore it at their own peril. Written By: Dan Juberg When the Centers for Medicare & Medicaid Services (CMS) proposed its new payment framework that (…)
The Society of Actuaries’ (SOA) recently published their study titled “Accuracy of Claims-Based Risk Scoring Models”. It evaluated 11 vendors on their ability to predict costs using Truven Marketscan® commercial claims dataset of 1 million members. The highlights are that Forecast (now Lumeris): Beat the 2nd best vendor at predicting people with the top 1% of costs by (…)