Louisiana Children’s Medical Center, Inc. (LCMC Health) is a five-hospital integrated health system based in New Orleans, LA. After several years of testing value-based programs and payment models, LCMC Health partnered with Lumeris to design and operate a scalable population health model, capable of meeting the needs of providers, payers, and patients across the region.
Building the Foundation: Establishing a Population Health Services Organization (PHSO)
Together, LCMC Health and Lumeris developed a tailored business plan and implementation roadmap to establish a Population Health Services Organization (PHSO), providing the resources and expertise to enable an outcomes-driven model.
To operationalize the strategy, Lumeris and LCMC Health implemented the Lumeris model, which identifies five essential components of a PHSO:
- Governance and leadership
- Provider engagement, network development and practice transformation
- Payer strategy and engagement
- Care delivery programs
- Technology and analytics infrastructure
“We’ve worked closely with Lumeris to educate our administrative and clinical leadership on the key components of a Population Health Services Organization (PHSO). We are transforming the way we deliver healthcare and we can’t do that without buy-in from across our health system. Executing on all five PHSO components is critical to our success and will allow us to effectively transition from a fee-for-service to a value-based care model across LCMC Health.”
– Meg Vitter, Vice President, Population Health
LCMC Health and Lumeris achieved key milestones in the implementation of the PHSO:
1. Governance and leadership
LCMC Health and Lumeris worked together to establish LCMC Health’s population health division, including leadership, governance, and staffing to jump start PHSO operations.
Key learning: Prioritize collaboration and communication by aligning the PHSO vision and objectives at all levels of the organization.
2. Engage a physician network designed for value-based care
LCMC Health established LCMC Healthcare Partners (LHP), a provider-led clinically-integrated network (CIN) organized around the principles of value-based care, and utilized the Lumeris Nine C’s® Playbook to design a custom physician engagement model.
Key learning: Organize and engage physicians to act like a unified group focused on delivering outcomes, using proven methodologies and effective governance.
3. Reformulate the payer strategy
LCMC Health and Lumeris established the contracting strategy and implemented a plan for value-based Medicare Advantage, traditional Medicare, Commercial, and Medicaid contracts.
Key learning: Fostering collaborative payer and provider relationships requires alignment around delivering high quality, cost effective care.
4. Redesign the care delivery model for population health
LCMC Health and Lumeris created new care delivery programs within the PHSO to support population health through quality improvement, care coordination, and pharmacy initiatives.
Key learning: New care delivery programs focused on Accountable Primary care require coordinated resources and processes that enhance the provider-patient relationship.
5. Deploy population health analytics and IT infrastructure
Lumeris worked with LCMC Health to implement Lumeris’ Accountable Delivery System Platform (ADSP)® for population health analytics and care management to support a multi-payer, multi-population strategy.
Key learning: Getting actionable information to the right users at the right time is foundational for delivering value-based care.
“Over the past 18 months our partnership with Lumeris has allowed us to expedite our network creation and lay a strong foundation for LCMC Healthcare Partners (LHP). Moving forward, we will continue to integrate LHP into our health system and work to establish ourselves as the leading physician-led network in our community. In partnership with Lumeris, we have designed LHP to improve quality and cost outcomes, engage providers, and align payers as our healthcare delivery model transitions from fee-for-service to value-based care.”
– John Heaton, MD, President, Clinical and System Operations