ST. LOUIS — Lumeris, the industry leader in value-based care solutions, today announced that the Centers of Medicare and Medicaid Services (CMS) has awarded long-time Lumeris client Essence Healthcare 4.5 out of 5 stars in its annual quality assessment of Medicare Advantage plans. The St. Louis-based Essence Healthcare has earned a 4.5 star rating or better for seven consecutive years.
“We’re honored that CMS has once again recognized Essence Healthcare for our high-quality performance and for achieving a high level of consumer satisfaction with our services,” said Richard Jones, CEO of Essence Healthcare. “Our collaboration with Lumeris has been instrumental to our success and allowed us to remain focused on protecting the health and wellness of our Medicare beneficiaries. The Lumeris value-based model continues to incent and enable providers to optimize their clinical and financial success through the efficient delivery of patient care.”
Essence Healthcare, which serves over 60,000 beneficiaries across Missouri and Illinois, offers a unique collaborative approach to Medicare Advantage insurance by working with providers in a virtual integrated delivery system. Lumeris supports Essence Healthcare’s efforts with transformative technology and engagement services that give providers the actionable clinical and financial data they need to proactively manage and coordinate patient care.
“Essence is among an elite number of Medicare Advantage plans that achieved a 4.5 star rating or higher for 2018, and the only HMO plan in Missouri to earn that distinction,” said Jones. “By maintaining a high star rating for seven straight years, we have demonstrated the power and success of a collaborative payer and provider approach that leverages innovative technologies and effectively engages physicians and consumers to drive adherence to clinical and quality measures.”
The Star Ratings system allows Medicare beneficiaries, their families and caregivers to compare the quality of available health and drug plans. Plans are rated on a 1 to 5 star scale, with 1 star representing poor performance and 5 stars representing excellent performance. Less than 19 percent of Medicare Advantage Part D plans earned 4.5 stars or higher for 2018.
Lumeris serves as a long-term operating partner for organizations that are committed to the transition from volume- to value-based care and delivering extraordinary clinical and financial outcomes. We guide health systems and providers through seamless transitions from volume to value, enabling them to deliver improved and more affordable care across populations—with better outcomes. And, we work collaboratively with payers to align contracts and engage physicians in programs that drive high-quality, cost-effective care with satisfied consumers—and engaged physicians.
An industry recognized leader, Lumeris was awarded 2017 Best in KLAS for value-based care managed services for helping clients deliver improved clinical and financial outcomes. This was the second year we received this distinguished award. For the past seven years, Essence Healthcare, Lumeris’ premier client with more than 63,000 members in Missouri and Illinois, has received 4.5 to 5 Stars from the Centers for Medicare and Medicaid Services. We enjoy working with all of our clients, delivering these same results, and aligning our proven multi-payer, multi-population model with their value-based care vision.