Stanford Medicare Advantage plan seeks sustainable growth and continued innovations to serve seniors in collaboration with Lumeris.
ST. LOUIS, MO — March 19, 2019 — Lumeris, an industry leader in value-based care, and Stanford Health Care, one of the nation’s leading academic medical centers, have agreed in principle to a long-term collaboration for the further development of Stanford Health Care Advantage, a Medicare Advantage (MA) plan in Northern California. Once finalized, Lumeris will help optimize and grow the MA plan throughout the region and support Stanford Health Care’s transition to a collaborative, provider-led value-based care delivery model.
The collaboration calls for Lumeris to assume key plan operations by leveraging its proven Collaborative Payer® Provider Model that aligns payer, provider, and consumer incentives with technology-enabled operations leading to improved outcomes. Integrating claims, electronic health records, lab, pharmacy and social determinants of health data through advanced analytics will enable Stanford Health Care to bring leading operational capabilities that support improving care quality performance measurement, population health management, and member services. The decision to move forward with Lumeris was the culmination of an 18-month evaluation process for Stanford Health Care, during which a range of potential collaborators were considered.
“We are very pleased to begin this close collaboration with Lumeris, as we bring our entire enterprise toward improving value,” said David Entwistle, president and chief executive officer of Stanford Health Care. “Their heritage with provider-led MA plans; the investments they have made in creating technology over time to support fundamentally sound provider engagement practices; their commitment to considering multiple populations within the value chain; and their willingness to work with us to advance Stanford Health Care’s commitment to accelerating innovation for compassionate, personalized care made them a clear choice.”
Lumeris has more than 10 years of experience working with providers to deliver industry-leading clinical and financial outcomes. The company has developed a proven transformative care delivery model that emphasizes patient wellness and the pursuit of the Triple Aim Plus One, defined as better health outcomes, lower costs, enhanced patient experience, plus markedly improved physician satisfaction. Lumeris’ data-driven care delivery model consistently improves value-based outcomes across populations.
“Stanford Health Care is one of the most innovative integrated academic healthcare systems in the country, so it is an honor for Lumeris to enhance and augment that tradition, helping them care for existing Medicare beneficiaries, driving the next growth phase of Stanford Health Care Advantage, and addressing the needs of other risk-based populations they serve,” said Mike Long, chairman and chief executive officer of Lumeris. “We look forward to helping the entire Stanford Health Care enterprise make a seamless transition to value-based care through our model that engages physicians while improving outcomes and patient experience.”
In addition, Stanford Health Care and Lumeris will jointly pursue deploying new innovations to serve the community, including the use of artificial intelligence (AI)-enabled diagnostics, innovative clinical pathways, and the use of digital capabilities to better connect members with providers, all of which are being developed at Stanford.
Entwistle concluded: “Medicare Advantage remains a key area of focus for us, and we’re looking forward to working closely with Lumeris to create a product where seniors find significant value.”
About Stanford Health Care Advantage
Stanford Health Care Advantage is a Medicare health plan currently offered to Medicare beneficiaries residing in Alameda, San Mateo and Santa Clara County. Built on the foundation of Stanford Health Care’s long-standing expertise in care delivery, Stanford Health Care Advantage brings the advanced clinical capabilities of Stanford Medicine and the coordinated health care experience that Medicare beneficiaries expect and deserve.
Lumeris is a value-based care managed services operator for health systems and providers seeking extraordinary clinical and financial outcomes. Lumeris aligns providers and payers across populations with technologies, processes, behaviors and information to achieve high-quality, cost-effective care with satisfied consumers — and engaged physicians. For the past eight years, Lumeris with Essence Healthcare, its inaugural client and learning laboratory with more than 65,000 Medicare members in Missouri and Illinois, has received 4.5- to 5-Star Ratings from the CMS and produced the highest consumer and physician satisfaction scores in the industry along with significantly better clinical outcomes and lower costs. For more information, go to www.lumeris.com.
Stanford Health Care