Oct 14 2021 | Press Release | By

Medicare Advantage Plans Across the United States Powered by Lumeris’ PHSO, the Industry’s Leading Value-Based Care Solution, Achieve CMS’ Highest Ratings

Lumeris’ Flagship Medicare Advantage Plan, Essence Healthcare, Receives CMS’ Highest 5-Star Rating

St. Louis, MO — Oct. 14, 2021 — Enabled by Lumeris’ population health services organization (PHSO), Essence Healthcare achieved an overall plan rating of 5.0 Stars by CMS, the highest rating possible. In addition, Medicare Advantage plans Lumeris has built jointly with health systems across the country including BayCarePlus Medicare Advantage (FL), Mary Washington Medicare Advantage (VA), PHP Medicare (MI), and Stanford Healthcare Advantage (CA), all received CMS plan ratings of 4.0 or higher.

Lumeris’ commitment to quality has enabled Essence Healthcare to perform in the top 2% of all Medicare Advantage plans in Star performance over the last 11 years, demonstrating the power of Lumeris’ PHSO to produce over time. Every year, CMS evaluates plans based on a 5-star rating system. Star ratings are based on an MA plan’s performance metrics which includes patient satisfaction, chronic conditions management, and screenings.

“We congratulate Essence Healthcare and our other Medicare Advantage health system partners,” said Mike Long, Chairman and CEO of Lumeris. “Together we are transforming healthcare delivery in the U.S. forever. Our PHSO ensures health systems and their patients receive the best outcomes available, both financially and clinically. Our scalable model can be implemented in any geography, for any population to help any healthcare organization achieve results like Essence Healthcare.”

Lumeris’ PHSO brings the industry’s most comprehensive, market-leading technology and enablement capabilities to health system and provider partners looking to perform in value-based care. Those capabilities include supporting 5.0 Star Medicare Advantage plans, like Essence Healthcare, and additional 15 market deployments with health systems across the US.

“This 5-Star rating again demonstrates that predictable quality outcomes and financial results in value-based models are achievable at scale, via the deployment of our PHSO,” said Debbie Zimmerman, Corporate Chief Medical Officer for Lumeris. “Nearly every health system is experiencing the move toward value, and we believe it’s critical to have an experienced operating partner to do it efficiently with excellent patient outcomes. Our solution is completely transferrable and scalable for health systems across the country. Together with our health system partners, we are accelerating the country’s journey to value.”


Lumeris enables health systems to successfully deliver exceptional value-based care through its market leading population health solution – the PHSO (Population Health Services Organization). The PHSO is the best solution in the market for health systems looking to manage outcomes for Medicare, Medicaid, Commercial and Individual populations. Lumeris has partnered with leading health systems to deploy its PHSO to more than 1 million patients and 7,000 physicians, managing $10B of medical spend in 15 markets around the US. By providing health systems with a comprehensive value-based care delivery model, enabled by the industry’s best predictive analytics and technology-enabled workflows, Lumeris’ health system partners consistently deliver more accessible, higher quality, lower cost, sustainable health outcomes. To learn more about Lumeris, please visit www.lumeris.com.

Based in St. Louis, Essence Healthcare serves over 65,000 members today and is growing its successful model in new markets across the country. Essence Healthcare leverages Lumeris’ PHSO to produce quality and financial results that rank it in the top 2% of all MA plans over the last 11 years. The PHSO allows Essence Healthcare to be truly collaborative and aligned with providers to deliver an exceptional member experience with the industry’s highest patient and physician satisfaction. To learn more about Essence Healthcare, please visit www.essencehealthcare.com.To learn more about Essence Healthcare, please visit www.essencehealthcare.com.


Marcus Gordon


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