Guest Blog: Automated Reporting: Helping Make Timely and Critical Decisions// posted by Eric Mueller
Reports, dashboards, analytics, and workflow all serve as essential parts in achieving the Triple Aim Plus One: better health outcomes, lower costs and improved patient plus physician satisfaction.
Guest Blog: Better Care at Lower Cost for People with Multiple Health and Social Needs// posted by Dr. Deborah Robin
In my role at Lumeris I often get asked by our clients, “What does care management really mean?” For me, having spent decades practicing geriatric medicine and teaching the principles of post-acute care coordination at a private research university and medical center, care management can be defined, most completely, as better care at lower cost for people with multiple health and social needs.
Guest Blog: Clinical Data Integration: The First Step Toward Value-Based Care and Achieving the Triple Aim Plus One// posted by Keith Blankenship
“Big data” has become a big, intimidating buzz phrase in health care. Health systems and provider groups are all trying to collect large amounts of clinical data, make it meaningful, and according to the American Hospital Association, use it to “facilitate the coordination of patient care across conditions, providers, settings, and time.” While collecting clinical data is a natural first step on the road to value-based care, the integration of that data is often complex, costly and time consuming.
Guest Blog: Managing Risk and Revenue in the Health Insurance Marketplace// posted by Terri Bellmore
In the coming months, payers will assume risk as a predicted seven million previously uninsured Americans enter the health care system. Because of this, I’m pleased to offer guest commentary on Mike Long’s blog about the important and timely topic of Risk Adjustment and Revenue Management in the Health Insurance Marketplace.
Accountable Care 2.0: It’s a Journey, Not a Program// posted by Jim Hansen
CMS released a long-awaited checkpoint status on its Pioneer ACO program. Of the 32 entities enrolled in the program, according to CMS...
Health Information Exchange Revisited// posted by W. Michael Long
Next week I’ll be traveling to D.C. to speak at the Fourth National Accountable Care Organization Summit sponsored by the Engelberg Center for Health Care Reform at Brookings and The Dartmouth Institute for Health Policy & Clinical Practice. The topic is Health Information Exchange (HIE). This is a ...
What is the Future State Vision for Health Care Delivery System Transformation?// posted by Jim Hansen
The country is in the midst of an unprecedented transformation of the health care system and may even be at a ‘tipping point’, yet many of us find it astounding that we have no official (or unofficial for that matter) collective vision of where we are headed, thus how the heck do we know if we are on the right path to get there?
Are Happier Physicians the Answer to Our Health Care Dilemma?// posted by W. Michael Long
I have used the last two blog posts to introduce the Accountable Primary Care Model*, or the Nine C’s* for short. To illustrate the power of the model, I used examples of some incredibly passionate and committed primary care physicians to demonstrate the first six C’s. I am ...
Accountable Care Doesn’t Require Changing Physician Behavior!// posted by W. Michael Long
How can that be? Isn’t accountable care all about driving physician behavior change? Not really. Instead, accountable care is unlocking the behaviors that physicians have always had, but were constrained to demonstrate. There is a big difference. Behavioral scientists say that changing fundamental human behaviors is extremely difficult ...
The Key to Getting Real Results from Accountable Care Initiatives: Do it Right or Don’t Do it at All// posted by Jim Hansen
The rumors are starting to be heard and the rumblings are starting to be felt. Will there be major financial fallout under accountable care and specifically CMS’s regulatory ACO programs?
Accountable Primary Care: What Can We Learn From Golf?// posted by W. Michael Long
In last week’s blog, I talked about how a primary care physician, Dr. Smith, changed his behavior, and subsequently his patient’s behavior, maintaining the patient’s health while saving the system $70,000/year. This behavior change was made possible in part by the availability of new tools, information and incentives. ...
What Does a Practicing Accountable Physician Look Like? Do They Behave Differently?// posted by W. Michael Long
Our country is blessed with the finest physicians in the world. They are the best trained and have access to the best medical technology and services. You would think we would have a running dialogue around the country celebrating and promoting this collective national asset. Instead, there is ...
Keeping Doctors at the Center of Health Care// posted by W. Michael Long
The growing reality of health care reform and the cauldron of conflict it creates between the creaking legacy of volume-based reimbursement and new, largely unproven methods of shifting more financial risk to physicians is upon us. A side effect is unprecedented uncertainty and anxiety among American physicians. Decades ...
It’s Time!// posted by W. Michael Long
Last week’s Time feature “Bitter Pill” raised U.S. health care costs to a new level of public awareness. Regardless of the assertions made in the article, hospitals are an essential component in the health care delivery system in our country. The historical multi-mission role hospitals play in clinical ...
Accountable care 2.0 offers promise of success beyond today’s accountable care 1.0 maturity level approach// posted by Jim Hansen
The ominous declaration of “The Coming Failure of Accountable Care” is creating quite the buzz in accountable care and health policy circles, particularly given that the declaration was made by the highly respected Harvard Business School professor and innovation researcher Clayton Christensen and colleagues in an article that was posted recently in The Wall Street Journal.
Accountable Care: A Cost-Control Experiment?// posted by W. Michael Long
A lot of people are talking about accountable care as a cost-control experiment. That assertion misses the triple aim of accountable care: cost, quality, and satisfaction. Further, satisfaction must include both the provider and recipient of health care services. Focusing on just patient satisfaction is a fool’s errand ...
Nine C’s of Successful Accountable Primary Care Delivery// posted by Jim Hansen
The Accountable Primary Care Model: New Hope for Medicare and Primary Care
Has Health Care Industry Transformation Reached its Tipping Point?// posted by Jim Hansen
Quickly out of the gate for 2013, Health Affairs featured the theme of Transforming the Delivery of Health Care in its January edition, Arnold Milstein MD’s Code Red & Blue – Safely Limiting Health Care’s GDP Footprint headlined the New England Journal of Medicine, and CMS announced a new wave of 106 additional ACOs to their program.
Automated Reporting Webinar Video: Enabling Value-based Decisions// posted by Cara Knox
The Lumeris solution for Automated Reporting gives health systems and health plans the tools they need to use data to make value-based decisions.
Lumeris to Present at AHIP’s Operations and Technology Forum// posted by Cara Knox
Session Will Explore Collaborative Payer-Provider Strategy and Tools for Transforming Practice Operations to Support New Business and Care Delivery Models.
Care Management: Better Care at Lower Cost for People with Multiple Health and Social Needs// posted by Cara Knox
Lumeris’ care management webinar 'Better Care at Lower Cost for People with Multiple Health and Social Needs' is now online.
New Hope for Primary Care: The Accountable Primary Care Model// posted by Cara Knox
Watch the National Accountable Care Congress breakout session “New Hope for Primary Care: The Accountable Primary Care Model” presented by Tom Doerr, MD, Director of Innovation Research, Lumeris and Deborah W. Robin, MD, MHCM, Medical Director, Lumeris.
Health 2.0 Presentation: Big Data Tools for Population Health Management// posted by Cara Knox
Lumeris’ Jim Hansen, Vice President, Health Policy discusses the importance of virtualizing health care functions while demonstrating the Care Management Solution in the Lumeris Accountable Delivery System Platform (ADSP).
The Affordable Care Act and Physicians: A Prescription for Change// posted by Cara Knox
Tom Doerr, MD, Director of Innovation Research, Lumeris for Becker's Hospital Review - In March 2010, the Patient Protection and Affordable Care Act was officially signed into law. As a result, in just a few short months, a projected 7 million previously uninsured people will become health plan consumers under the nation's existing fee-for-service reimbursement system. At the same time, the PPACA is introducing new care delivery and business models including the Pioneer accountable care organization and Medicare Shared Savings Program ACO pilots that incentivize providers for the value that they provide.
Collaborative Risk Adjustment and Care Coordination for Medicare Advantage and Dual Eligibles// posted by Cara Knox
AHIP’s 2013 Medicare and Medicaid Conference September 24, 2013 Washington D.C. David Corrigan, Director of Informatics, Lumeris David Corrigan, Director of Informatics for Lumeris, spoke at AHIP’s 2013 Medicare and Medicaid Conference addressing how taking a collaborative approach to care coordination and risk adjustment to treat patients with ...
Data Integration As The First Step// posted by Cara Knox
Keith Blankenship, Vice President of Technical Solutions, Lumeris, HIEWatch - Recently, "big data" has become an intimidating buzz phrase in healthcare. Health systems and provider groups are trying to collect large amounts of clinical data and make it meaningful -- and they're finding that the integration and analysis of that data across multiple platforms is anything but simple.
Lumeris to Present at AHIP’s 2013 Medicare and Medicaid Conference// posted by Cara Knox
Session Will Explore a Collaborative Approach to Prospective Risk Adjustment and Care Coordination for Effective Management of Complex Populations ST. LOUIS, September 18, 2013 – Lumeris, an accountable care delivery innovation company, today announced that Director of Informatics, Dave Corrigan, will deliver a presentation at America’s Health Insurance ...
Mostashari’s departure leaves big shoes to fill// posted by Cara Knox
By Jim Hansen, Health Management Technology - A crusader of electronic health records (EHR) and meaningful use (MU) is stepping down as National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services after serving for two-plus years in that position and four years at the agency.
Executive Insight Article: Strategies to Identify the ROI of an ACO// posted by Cara Knox
By James L. Starr and Richard Jones - A new business model is now being embraced by the U.S. healthcare system. Accountable care – in which ROI is measured not by the volume but the value of services, plus an organization’s ability to meet the goals of the Triple Aim – is transforming the industry.
Lumeris Medical Chief: Move From Fee-for-Service to Population Health Management for ACOs to Succeed// posted by Cara Knox
Best's News Service - Physician satisfaction is a crucial part of the model for accountable care organizations, according to Debbie Zimmerman, the chief medical officer for Lumeris. She also spoke to Best's News Service...
News Release: Lumeris Executives Spotlight Accountable Care at Premiere Industry Events// posted by Cara Knox
CEO Michael Long to Discuss Health Information Exchange at ACO Summit Medical Director Deborah Robin Provides Collaborative Payer Model Overview at AHIP
News Release: Lumeris Enhances Care Management Capabilities in Transformational Accountable Delivery System Platform// posted by Cara Knox
Lumeris today announced enhancements to its transformative Accountable Delivery System Platform (ADSP), with the expansion of its care management offering to provide the industry’s most robust solution for population health.
News Release: Independence Blue Cross, Abington Health, Lumeris Create Cutting-Edge Accountable Care Initiative to Improve Quality, Lower Costs, Increase Satisfaction// posted by Cara Knox
Independence Blue Cross (IBC), Abington Health, and Lumeris announced today the creation of an accountable care initiative using Lumeris’ transformative technology and services to improve the coordination of patient care, lower overall health care costs, and increase patient and physician satisfaction.
News Release: SCL Health System Announces New Accountable Care Strategy// posted by Cara Knox
SCL Health System, a faith-based, not-for-profit health care organization, announced today the launch of an accountable care strategy designed to improve the quality of patient care and lower costs at SCL Health System hospitals and clinics.
News Release: Essence Healthcare, powered by Lumeris technologies, earns 4.5-star rating// posted by Cara Knox
Lumeris announced today that one of its health plan customers, Essence Healthcare, was once again awarded a 4.5-star rating from the Centers for Medicare and Medicaid Services, making it the highest-rated Medicare Advantage plan in the St. Louis area for the second year in a row.
News Release: Lumeris establishing technology innovation center in Austin// posted by Cara Knox
Lumeris, a rapidly emerging healthcare technology company has chosen Austin to build a software engineering and innovation center. Lumeris has immediate requirements for 100 software engineers, project managers and consultants and major expansion plans in 2013 and beyond.
News Release: Blues Plans, Lumeris Partner to Acquire Nation’s Largest Real-Time Health Care Communication Network// posted by Cara Knox
Three of the nation’s leading Blue health plans that work with more than 70,000 physicians and hospitals to deliver care to more than 11 million people announced today they are partnering with health IT provider Lumeris Corp. to acquire NaviNet. NaviNet is the nation’s largest real-time communication network for physicians, hospitals and health insurers.
News Release: BlueCross BlueShield Venture Partners Joins $70 Million Private Investment Round in EGHC, the Parent of Lumeris Corporation// posted by Cara Knox
Essence Group Holdings Corporation (EGHC) today announced that BlueCross BlueShield Venture Partners, managed by Sandbox Industries, has joined Kleiner Perkins Caufield & Byers and Camden Partners in a private investment in Essence.
News Release: Lumeris Parent Closes $61 Million Private Investment Round// posted by Cara Knox
Essence Group Holdings Corporation (EGHC) today announced it has raised $61 million in a private funding round that included new investors Camden Partners and Kleiner Perkins Caufield & Byers.
News Release: Lumeris to Present at Institute of Medicine, Health and Human Services Conference// posted by Cara Knox
Lumeris, an expert in using software and services to enable more accountable health care, today announced its invitation to present at the upcoming Health Data Initiative Forum on the campus of the National Institutes of Health. The company joins a handful of other health care innovators invited to participate in the second annual gathering on June 9.
News Release: W. Michael Long, Former Healtheon / WebMD Chairman and Chief Executive, Named EGHC President and CEO// posted by Cara Knox
Essence Group Holdings Corporation (EGHC) today announced the appointment of W. Michael Long as its president and chief executive officer. Long continues in his role as chairman of the board. He succeeds Frank Ingari, who will become vice chairman of the company’s board and president of its 4+ star Medicare Advantage insurance business.
News Release: Network Health Plan Chooses Lumeris to Improve Quality, Cost of Health Care in Northeast Wisconsin// posted by Cara Knox
Lumeris today announced that Network Health Plan, a part of the Affinity Health System, has licensed the company’s popular Accountable Delivery System Platform to improve the quality and lower the cost of health care delivered to more than 42,000 members in northeast Wisconsin.
News Release: Mayo Clinic President and CEO Emeritus to Join EGHC Board// posted by Cara Knox
Essence Group Holdings Corporation (EGHC), the parent company of Lumeris and Essence Healthcare, today announced that Denis A. Cortese, M.D., a champion of high-quality and patient-centered health care, will join the company’s Board of Directors.
News Release: Lumeris Selected by Blue Cross and Blue Shield of Florida to Improve Quality of Care in South Florida Region// posted by Cara Knox
Lumeris today announced Blue Cross and Blue Shield of Florida, Inc., (BCBSF) has implemented the company’s innovative Accountable Delivery System Platform to help lower costs and enhance the quality of health care delivered to BCBSF Medicare Advantage enrollees in southern Florida.
White Paper: The Value of Integrating EMR and Claims/Cost Data in the Transition to Population Health Management// posted by ADSI
When EMR data is combined with claims/cost data, a physician gains a complete view of a patient’s medical history. In this white paper, we discuss the importance of combining claims, EMR, admission, lab, and pharmacy data, and how information supported by tools and workflows — helps health systems, payers and providers make value-based decisions and achieve population health management.
White Paper: Navigating the Rise of Value-Based Care// posted by ADSI
The transition to accountable care presents hospitals with real and significant financial opportunities, as well as risks. But the risks become manageable when hospital leaders deploy solid strategic planning. Planning that must include an understanding of the unique challenges and opportunities that come with value-based payment arrangements.
White Paper: Clinical Data Integration// posted by ADSI
Clinical integration is a vital component to transforming the U.S. health care system. The challenges are complex, but emerging payment models are helping fulfill technology’s promise to improve information-sharing among payers and providers. An important step in increasing collaboration, lowering costs, improving quality, and boosting patient and physician satisfaction.
White Paper: Business Process Partnering for Value-Based Care Delivery// posted by ADSI
To establish and execute high performance business process partnering, 22 core competencies must be accounted for and addressed within the accountable care ecosystem.
Point of View: How the Nine C’s Help Accomplish the Goals of the Triple Aim Plus One// posted by Lumeris
Lumeris developed the Nine C’s℠ to ensure a powerful, proven framework for delivering the Triple Aim Plus One: quality, cost, plus patient and physician satisfaction. The Nine C’s offer providers a roadmap for making a successful transition from a volume-based to a value-based model.
Point of View: The Collaborative Payer Model// posted by Lumeris
The Collaborative Payer Model achieves proven results against the Triple Aim Plus One: better health outcomes, lower costs, and improved patient, as well as physician, satisfaction. And it offers valuable lessons for today’s government-sponsored and private-sector accountable care organizations.