Category: Thought Leadership

Guest Blog: Lumeris’ Population Health Effectiveness: Essence Healthcare Achieves 4.5-Star Rating

December 3, 2014 | By

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.


The transition to value-based care continues to accelerate

March 28, 2019 | By

Market and regulatory pressures continue to drive health systems toward value-based payment. In a survey of leading health systems, half of executives state that the shift to value-based care is happening either quickly or very quickly at their organization. Moreover, respondents indicate that 23% of total care delivery in the last quarter of 2018 was (…)


Thinking of Starting a Medicare Advantage Plan? 2021 Starts Now

March 26, 2019 | By

Provider-sponsored health plans and Medicare Advantage are gaining traction as a critical strategy for profitable, value-based care. However, many provider organizations underestimate the necessary lead time and effort required to move from consideration to activation. Planning for a 2021 launch needs to begin now starting with a detailed market and organizational feasibility study for standing (…)


Guest Blog Series: Part 3: How The Nine C’s Help Accountable Providers Engage Accountable Consumers

August 20, 2014 | By

With increasing responsibility for their own care, consumers are realizing the importance of their providers and care teams. And, in the age of the Affordable Care Act, more and more previously uninsured patients are realizing how vital it is to manage their own health care to keep costs manageable.


Making Sense of Medicare: One Health Insurance Agent’s Approach to Educating Today’s Seniors

March 21, 2019 | By

Let’s have lunch! Lee Green is not your typical health insurance agent. Formerly the chief sales and marketing officer at a provider-sponsored plan, Lee took early retirement to start a new career doing the work he had overseen for years. After a two-year stint as a benefits consultant, he struck out on his own, focusing (…)


Guest Blog Series: Part 2: How The Nine C’s Help Accountable Providers Engage Accountable Consumers

August 19, 2014 | By

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®.


Guest Blog Series: Part 1: How The Nine C’s Help Accountable Providers Engage Accountable Consumers

August 18, 2014 | By

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.


Are You Keeping Your Executives Accountable During the Transition to Value? – 2019’s Top 5 Board Questions

March 12, 2019 | By and

Increasingly gloomy credit rating forecasts threaten to cast a cloud over the not-for-profit health system sector[1].  Traditional business models are under serious pressure and as value-based care and payment accelerates into an unavoidable but crucial strategy, these are the questions progressive Board Members are asking themselves: 1.    What resources are dedicated to managing risk today (…)


Critical Drivers for Success in Value-Based Care

March 1, 2019 | By

Health systems across the country are accelerating their move toward value-based care. Whether they are looking to manage value-based contracts with payers in the market or launch their own health plan, providers are realizing that much of the difficulty in transformation lies in the “how”. Operationalizing value-based models successfully can be challenging for organizations new (…)


Disruption in Healthcare Offers New Opportunities for Health Systems

January 31, 2019 | By

As healthcare accelerates toward value-based models, health systems must find ways to remain relevant in the new era. New strategies, business models and care delivery innovations continue to change the healthcare landscape. To find out more about what leading health systems are saying about trends in the market, click here to read surveys from the (…)


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