Proven in practice. Powered by purpose.
Since Dr. Tom Doerr’s first innovation in the exam room, Lumeris has spent two decades transforming primary care—earning its place as a leader in value-based care and the pioneer of Primary Care as a Service.
Lumeris began in the exam room—not a boardroom.
In the early 2000s, Dr. Tom Doerr, a practicing physician in St. Louis, saw a truth too many in healthcare knew but few were addressing: physicians deliver their best care when supported by systems designed to work with them—not around them.
He started small, creating one of the first clinical decision support tools to bring evidence-based medicine to the point of care. But the vision quickly grew. In 2004, a group of physicians, frustrated by a local health plan that hindered rather than helped, took the bold step to build their own. They launched Essence Healthcare—a Medicare Advantage plan putting physicians firmly in control. They proved that when incentives are aligned, care becomes proactive, outcomes improve, and costs come down.
“20 years of proof that healthcare transformation isn’t theory—it’s practice.”
From those roots, Lumeris was born—first as an operator of value-based care, then as a national enabler of it. By combining the rigor of running one of the country’s highest-rated health plans with deep technology and operational expertise, Lumeris developed one of the most proven infrastructures for value-based care in the nation.
For over 15 years, we’ve partnered with health systems and physician organizations to make transformation real—aligning incentives, reducing administrative burdens, and delivering measurable results.
Driving the shift from Value-Based Care to Primary Care as a Service.
Our work in value-based care was never an end point—it was a foundation. The next chapter came from asking a bigger question: What if every patient in America had access to high-quality primary care, whenever and wherever they needed it—and every physician had the time, tools, and support to practice the medicine they were called to do, without the crushing overhead that too often stands in the way, and get paid for doing it right?
For years, these questions were hypothetical. With modern advances in artificial intelligence, cloud computing, nationwide interoperability standards, and secure real-time data exchange, they can finally be answered—clearly, confidently, and at scale.
“AI that expands access, eases burdens, and elevates outcomes.”
The answer is Tom, named after our founder and family doctor, Tom Doerr—our Primary Care as a Service (PCaaS) platform. Tom combines Lumeris’ operational depth with elegant, responsible AI to close the primary care gap. It integrates data from 63 EHR pipelines and 75 payer feeds, normalizing tens of billions of clinical and consumer data points. The result: intelligent, timely actions that support patients and their care teams in real time.
Tom’s reach goes beyond value-based care models. It’s designed to work for every health system, every physician, and every patient—whether in Medicare Advantage, ACO REACH, commercial, or fee-for-service settings. It’s primary care that is:
- Physician-first – augmenting clinical teams and handling routine tasks, not a replacement for human care
- Always accessible – proactive outreach, between-visit care, and continuous engagement
- AI-enabled and human-led – automation with appropriate clinical guardrails, informed by decades of real-world healthcare experience
“Built on real-world results, tested under pressure, proven to last.”
Delivering impact for every stakeholder.
For patients, it means better access to primary care, coordinated treatment plans, and personalized outreach that helps them stay healthy between visits.
For primary care teams, it means practicing at the top of their license—spending more time influencing health outcomes and less time wrestling with fragmented data and administrative work.
For health system executives, it means improved quality performance, lower total cost of care, and sustainable growth across payment models.
For communities and long-term partners, it means a scalable, SaaS-based healthcare platform built on 20 years of operational proof, now accelerated by advanced AI and cloud capabilities through our strategic partnership with Google Cloud.
“People inspire change. Technology makes it possible.”
Starting with healthcare. Elevating with AI.
We didn’t start with AI. We started with healthcare. We built the systems, proved they work, and only then layered in intelligence to extend the reach of the care team. That’s why Lumeris is not just another healthcare technology vendor—it’s a partner built from the inside out, leading the way toward a future where primary care is proactive, personal, and available to all.
People inspire change. Technology makes it possible. That’s the Lumeris story—and we’re just getting started.
Early 2000s
A problem seen from the exam room
In St. Louis, Dr. Tom Doerr developed one of the first clinical decision support tools, sparking Lumeris’ physician-led approach to value-based care.
- 1st-generation clinical decision support tool tested in live patient care, not in a lab.
2004
Essence Healthcare launches as a physician-led Medicare Advantage Plan
We launched Essence Healthcare, proving that physician-led Medicare Advantage models improve outcomes, reduce costs, and boost patient satisfaction.
- 58,000+ members served
- 4.5 average CMS Star Rating
- Top-ranked in clinical and financial performance
2008
Merging vision and capability
Essence and Wellinx formed Lumeris Group Holdings, building a scalable, data-rich infrastructure to align payers, providers, and patients in value-based care.
- Collaborative Payer® model created
- National payer relationships established
2010
Lumeris launches nationally
We expanded nationwide, bringing health systems a proven value-based care enablement playbook grounded in real-world results.
- First multi-market deployments of the Lumeris model
- Partnerships in multiple U.S. states
2012
Launch of first purpose-built platform for accountable care
We introduced one of the first platforms for accountable care delivery—integrating EHR data, payer claims, and population health tools into a single care coordination solution.
- 30B+ clinical data points integrated
- 100+ payer relationships
- $9.3B+ managed medical spend under management annually
2013–2019
Scaling results through partnership
We partnered with health systems across the U.S., delivering 20–30% total cost of care reductions and industry-leading quality scores in value-based arrangements.
- 90%+ chronic disease reassessment
- 87% BP control
- 85% breast cancer screening
- 32% SNF length-of-stay reduction
2022
Advancing into ACO REACH and Downside Risk
We deployed ACOs in the ACO REACH model, achieving $41 million in gross savings through ACO REACH and Medicare Shared Savings Program (MSSP) contracts in 2023.
- Multiple downside-risk ACO deployments
- $41M gross savings in a single year
2023
Expanding Medicare Advantage markets
We extended our proven value-based care model to more Medicare Advantage plans, increasing access to high-value, coordinated primary care.
- Expanded MA coverage footprint across multiple new markets.
Today
AI-Powered Primary Care as a Service (PCaaS)
We launched Tom, our AI care orchestration platform for value-based care enablement, helping health systems nationwide close care gaps, scale primary care, and deliver proactive, personalized patient experiences.
- $55B claims ingested
- 63 EHR + 75 payer integrations
- 40+ large language models
Ready to shape the future of primary care? Let’s write the next chapter—together.