Leavitt Partners White Paper: Assessment of the Hospital Value-Based Purchasing Program// posted by Industry News
The HVBP program is an important effort by CMS to provide tangible incentives to hospitals to improve the quality of care that they are delivering. Current results show uneven performance both geographically and by different types of hospitals.
AMJA Report: Attributes Common to Programs That Successfully Treat High-Need, High-Cost Individuals// posted by Industry News
. Using literature review and interviews, AJMC has identified 8 shared attributes of programs, such as accountable care organizations, readmission initiatives, special needs plans, care transition programs, and patient-centered medical homes, that successfully treat high-need, high-cost patients.
McKinsey Report: Provider-Led Health Plans… The Next Frontier, or the 1990s All Over Again?// posted by Industry News
According to a new report from the McKinsey Center for US Health System Reform, there are currently 64 insurance plans led by providers like hospitals or healthcare systems available through the health insurance marketplaces. Next year, there will be 72.
NPR Article: Doctor Treats Homebound Patients Often Unseen Even By Neighbors// posted by Industry News
Although house calls may harken back to the country doctor of decades past, it could be the future of medicine. In 2013, about 2.6 million Medicare claims were filed for patient home visits and house calls. That's up from 2.3 million visits in 2009 and 1.4 million visits in 1999, according to Medicare statistics.
Washington Post Article: Patients’ Needs Addressed in ‘Person-Centered Health Care’// posted by Industry News
More than half of people receiving or providing care without a single health care manager, an aspect of person-centered care, didn’t think their care would improve much if they had one, while more than three quarters of those who had one said it improved things a lot.
Commonwealth Fund Report: Models of Care for High-Need, High-Cost Patients – An Evidence Synthesis// posted by Industry News
This brief analyzes experts’ reviews of evidence about care models designed to improve outcomes and reduce costs for patients with complex needs. It finds that successful models have several common attributes.
KFF Report: Medicare Advantage and Traditional Medicare – Is the Balance Tipping?// posted by Industry News
In this brief, Kaiser Family Foundation looks beneath national trends to examine Medicare Advantage penetration rates and growth rates in counties across the country to assess the extent to which Medicare Advantage plans are poised to cover more beneficiaries than traditional Medicare across the country.
PR Newswire Article: Centene Announces Overwhelming Shareholder Approval Of Merger With Health Net// posted by Industry News
The final results of a special Centene shareholder vote indicate that 99 percent of the shares voting at the special meeting voted in favor of the proposal, representing 85 percent of all outstanding shares.
Health IT Analytics Article: Population Health Management High Priority for Providers// posted by Industry News
This study conducted by eHealth Initiative shows the diversity of health IT utilization in population health management. Because respondents showed high engagement with population health management and data analytics, researchers state that the importance of those concepts is evident. However, integration of data and its usefulness serve as serious inhibitors.
AJMC Article: Healthcare Integration May Increase Commercial Health Spend// posted by Industry News
A new study in JAMA Internal Medicine has found that financial integration between physicians and hospitals has led to higher spending in outpatient care.
Healthgrades Article: New Research Finds Significant Number of Americans Not Getting Care at Right Hospitals// posted by Industry News
One out of every six patients in the U.S. received care in a hospital rated 1-star, according to new research released by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. Had those patients researched local doctors and hospitals to identify and select a physician practicing in a 5-star hospital for their specific procedure or condition, they would have faced a 71 percent lower risk of dying or a 65 percent lower risk of experiencing complications during their hospital stay.
Kaiser Health: One-Quarter Of ACOs Save Enough Money To Earn Bonuses// posted by Industry News
Health IT Outcomes Article: ACO Success Stories// posted by Industry News
PR Newswire Release: First National ACO Survey on Startup Costs// posted by Industry News
Government Health IT Article: ACOs Struggle With Data Sharing// posted by Industry News
Healthcare IT News Article: Looking Back to Before Data was Big// posted by Industry News
It's hard to go too long these days without hearing someone hype the benefits of big data. It's to the point where the term is all but a cliché. Hard to believe that's it's still a fairly recent coinage. "Maybe three years ago?" says Cynthia Burghard research director for accountable care IT strategies at IDC Health Insights, when asked when she first heard the now-ubiquitous term. "It's still relatively new, across all industries. Some industries have used pieces of the big data and analytics technology stack, but not in its entirety."
The Journal of the American Medical Association Article: The Anatomy of Health Care in the United States// posted by Industry News
In this article, publicly available data were used to identify trends in health care.
HealthLeaders Media Article: Preview: At CFO Exchange, Cost Reduction Tops Agenda// posted by Industry News
By Edward Prewitt, HealthLeaders Media - Senior financial executives gathered for HealthLeaders Media's annual CFO Exchange say their top priorities include managing overall cost reductions and changes to reimbursement models as a result of healthcare reform.
Healthcare Informatics Article: Physicians Not Prepared for Transition to Value-Based Care// posted by Industry News
By Rajiv Leventhal, Healthcare Informatics - According to a survey of 139 hospital and health system executives by the Healthcare Financial Management Association (HFMA), only 20 percent of physicians believe they are “very prepared” and have the necessary infrastructure to support quality and outcomes-based management. This reinforces the need for services that will help hospitals as they work with their physicians and physician practices to transition to the new models of care.
The New York Times Article: Obamacare’s Other Surprise// posted by Industry News
We’ll just have to wait and see whether the Affordable Care Act, as the health care law is officially known, surprises us on the downside. But there is one area where the law already appears to be surprising on the upside. And that is the number of health care information start-ups it’s spurring. This is a big deal.
Healthcare Informatics Article: A Pennsylvania-Based Health Plan Engages with its Providers through an Analytics Platform// posted by Industry News
Independence Blue Cross and Abington Health have are collaborating on an initiative that could transform the reimbursement landscape of southeast Pennsylvania.
Healthcare IT News Article: Five Ways ACOs Benefit From Health IT// posted by Industry News
From faster communications to discovering new best practices, health IT will help ACOs surge ahead.
FORBES Article: Patients Warm To Nurse Practitioners, Physician Assistants// posted by Industry News
By Bruce Japsen, FORBES - U.S. consumers still like to see a doctor, but if they have to wait, they are happy to see a nurse practitioner or a physician assistant.
Becker’s Hospital Review Article: Fitch: Value-Based Payments Are Non-Profit Hospitals’ Greatest Challenge// posted by Industry News
By Jim McLaughlin, Becker's Hospital Review - The transition to value-based reimbursement from the volume-based model presents non-profit hospitals' greatest challenge, according to a report from Fitch Ratings.
Brookings Institution Article: Advancing Reform: Medicare Physicians Payments// posted by Industry News
By Kavita Patel, Brookings Institution - Our nation is in a sustained period of constrained finances and while the cost to repeal the SGR has been decreased to $138 billion, finding the offsets and mechanism to pay for such a solution will not be easy.
Kaiser Health News Article: Doctors Transform How They Practice Medicine// posted by Industry News
By Ankita Rao, Kaiser Health News - The buzz, and anxiety, in the medical profession is palpable – trade magazines tout new coping strategies, doctor groups discuss the transformation of practices.
Innovation.cms.gov Article: Health Care Innovation Awards Round Two// posted by Industry News
By innovation.cms.gov - The Centers for Medicare & Medicaid Services (CMS) has released a Funding Opportunity Announcement for round two of the Health Care Innovation Awards. Under this announcement, CMS will spend up to $1 billion for awards and evaluation of projects from across the country that test new payment and service delivery models that will deliver better care and lower costs for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollees.
Health Affairs Article: A Framework For Accountable Care Measures// posted by Industry News
By Richard Bankowitz, Christine Bechtel, Janet Corrigan, Susan D. DeVore, Elliott Fisher, and Gene Nelson, Health Affairs Blog - The Affordable Care Act included provisions to accelerate the transition to value-based payment, including Accountable Care Organizations (ACOs). Many private sector insurers, providers and employers also are moving in this direction.
Becker’s Hospital Review Article: Six Core Principles of a Redesigned Health System// posted by Industry News
By Sabrina Rodak, Becker's Hospital Review - The Physicians Foundation, a non-profit organization working to advance physicians' work and facilitate care delivery to patients, presents six core principles of a redesigned health system in a new report.
Brookings Institution Article: Bending the Curve: Person-Centered Health Care Reform// posted by Industry News
By Brookings Institution - A Framework for Improving Care and Slowing Health Care Cost Growth.
The Commonwealth Fund Article: In Pursuit of Better Care at Lower Costs: The Value of Cross-National Learning// posted by Industry News
The New York Times Article: A Health Provider Strives to Keep Hospital Beds Empty// posted by Industry News
Becker’s Hospital Review Article: Survey: Patient Satisfaction at Two-Decade High// posted by Industry News
Becker’s Hospital Review Article: AHA Report Suggests Metrics for Value-Based Care Strategies// posted by Industry News
Healthcare IT News Article: Business Process Changes, Not IT, Biggest Challenge for Providers// posted by Industry News
Healthcare IT News Article: HFMA Project Points to Power of BI// posted by Industry News
Center for Health Care Strategies Inc. Article: Adapting the Medicare Shared Savings Program to Medicaid Accountable Care Organizations// posted by Industry News
Health Leaders Media Article: Nine in Ten Health Plans Still Tied to FFS Model// posted by Industry News
American Hospital Association Resource Article: Continued Growth of Public and Private Accountable Care Organizations// posted by Industry News
Leavitt Partners Article: Leavitt Partners, in New White Paper, Compares ACOs to Managed Care Organizations// posted by Industry News
Healthcare Finance News Article: Healthcare leaders discuss the ACO keys to success// posted by Industry News
iHealthBeat Article: A Fork in the Road at HIMSS13: How Patients & Payment Are Forcing ‘Open’ Health IT// posted by Industry News
AHRQ Article: AHRQ Releases Toolkit to Reduce Hospital Readmissions// posted by Industry News
Family Practice News Article: PCPs drive reduction in Cleveland hospitalizations// posted by Industry News
The Advisory Board Company Article: Mapping Bundled Payments for Care Improvement (BPCI) initiative// posted by Industry News
Healthcare Payer News Article: AHIP Goes on the Offensive Over Proposed Cuts for Medicare Advantage Plans// posted by Industry News
Healthcare IT News Article: EMR and HIE See Big Adoption Numbers// posted by Industry News
AJMC Article: Medical Homes Require More Than an EMR and Aligned Incentives// posted by Industry News
The Commonwealth Fund Article: Turning Readmission Reduction Policies into Results: Some Lessons from a Multistate Initiative to Reduce Readmissions// posted by Industry News
Healthcare IT News Article: ACO Here, ACO There, ACO Everywhere & Vendor Response// posted by Industry News
News Release: Lumeris’ Client Essence Healthcare Receives Rare CMS 5-Star Rating// posted by Lumeris
Extraordinary Rating Validates Trailblazer Lumeris Collaborative Model While Creating a Scalable Playbook for Every Healthcare Organization in the U.S.
News Release: Lumeris Signs Agreement with HMO Louisiana, INC. To Assist With Launch of New Medicare Advantage Plan// posted by Lumeris
HMO Louisiana, Inc., a subsidiary of Blue Cross and Blue Shield of Louisiana, the largest nonprofit health insurer in the state, has chosen Lumeris.
News Release: Lumeris Adds New Hires to Team as Growth Continues// posted by Lumeris
Population health management industry pioneer experiences significant business growth as demand for solutions increases
News Release: Lumeris Continues Growth With Hire of New Medical Director – Dr. Michael Neill// posted by Lumeris
Dr. Michael Neill to offer clinical expertise in support of the development and implementation of technology-enabled solutions for population health management
News Release: Lumeris Continues Growth With Hire of New Medical Director – Dr. Paul Kaplan// posted by Lumeris
Dr. Paul Kaplan to offer clinical expertise in support of the development and implementation of technology-enabled solutions for population health management
Executive Insight Article: We Cannot Thin Slice Our Way to Transforming Healthcare// posted by Lumeris
Lumeris SVP & Head of Markets, Mark Roman shares insight into the need for ongoing collaboration and integration to transition to value-based care.
News Release: Lumeris Expands Executive Team With Hire of Andrew Cole// posted by Lumeris
Cole will serve as Chief Human Resource and Organizational Development Officer for leading population health management solutions provider
American Journal of Accountable Care Article: The Accountable Primary Care Model: Beyond Medical Home 2.0// posted by Lumeris
Lumeris thought leaders, Thomas D. Doerr, MD; Herbert B. Olson, FSA; and Deborah C. Zimmerman, MD, publish original research in the American Journal of Accountable Care detailing the new Accountable Primary Care Model.
News Release: Lumeris Helps Essence Healthcare Achieve 4.5-Star Rating for Four Years in a Row// posted by Lumeris
Lumeris Population Health Management Services Enable Health Plan to Optimize Clinical, Financial Operations
Healthcare Finance Article: The Meaning Of ‘Risk’ In An ACO// posted by Lumeris
Lumeris Chief Financial Officer, James Starr, discusses the role ACOs play in the evolution of care models and new financial models.
Healthcare Finance Article: Providers Slow To Enact Risk-Based Reimbursement Model// posted by Lumeris
Lumeris Medical Director, Dr. Jim Riopelle M.D. discusses the importance of physician adoption of population health management in a risk environment.
News Release: Noble Health Alliance Selects Lumeris for Quality Analysis, Reporting// posted by Lumeris
Noble Health Alliance (Noble) announced that it has chosen Lumeris to provide clinical data analysis and effective strategies for improving chronic disease management as part of Noble’s population health initiative. Noble’s CMO Susan L. Williams and Lumeris’ CEO Mike Long both comment on what the relationship means for their organizations.
Executive Insight Article: Accountable Care Success, More Than Just “Big Data”// posted by Lumeris
Lumeris’ Vice President of Technical Solutions Keith Blankenship discusses the elements beyond big data that are critical for accountable care success.
St. Louis Business Journal: Lumeris $71 million raise fuels strong venture capital quarter// posted by Lumeris
Lumeris helped with the St. Louis region’s strongest investment capital period over the past decade. In the previous two quarters, venture capital investment in the St. Louis region was $5.5 million (first quarter) and $19.6 million (second quarter). The significant increase to $78.5 million in the third quarter was a result of the equity financing received by Lumeris, $71 million.
St. Louis Business Journal: Rapid expansion: Lumeris to expand following $71 million investment// posted by Lumeris
Lumeris will use the $71 million in financing to expand into 20 markets before the end of 2014. W. Michael Long, Chairman and Chief Executive Officer of Essence Group Holdings Corporation and Lumeris said expansion will help the company contract with more health care organizations.
HIStalk: Healthcare IT News & Opinion Article: Top News// posted by Lumeris
Lumeris’ parent company announces $71 million in new financing.
Venture Beat Article: Lumeris takes $71M to expand population health management to 12 markets// posted by Lumeris
Coverage of Lumeris funding news and expansion from eight to 20 U.S. markets by the end of 2015.
Venture Capital Dispatch: The Wall Street Journal’s Blog: The Daily Startup: Payment-Tech VC Surges, M&A Should Follow// posted by Lumeris
Lumeris capital raise of $71 million is cited in The Wall Street Journal’s blog (Venture Capital Dispatch) about investment interest in the industry.
TechCrunch Article: Essence Group Holdings Raises $71 Million For Population Health Management Services// posted by Lumeris
Essence Group raises $71 million to enhance position in population health management market.
HIT Consultant Article: Population Health Management Company Lumeris Closes $71M in Funding// posted by Lumeris
Lumeris’ population health management solutions are featured, as well as the resulting $71 million in private-equity funding that will support expanding those solutions into 12 additional markets.
Venture Beat Article: Digital health startups have taken $2.2B in funding so far in 2014, already besting 2013 total (report)// posted by Lumeris
The $71 million received by Lumeris in private equity is included in the more than $2.2 billion (as cited by Rock Health) invested in the broad category of digital health care as a result of health care reform.
News Release: Lumeris’ Parent Company Closes $71 Million in New Funding// posted by Lumeris
Essence Group Holdings Corporation (EGHC), parent of Lumeris, a pioneer in population health management solutions, today announced that it has secured approximately $71 million in financing. The private-funding round includes capital from new and existing investors. Allen & Company LLC served as financial advisors.
St. Louis Business Journal Article: Lumeris raises $71 million in venture capital from group led by Kleiner Perkins// posted by Lumeris
Lumeris is featured as raising $71 million in funding from private equity companies.
St. Louis Post-Dispatch Article: Medical technology firm Lumeris raises $71 million in venture capital// posted by Lumeris
A MoneyTree report, compiled by PriceWaterhouse Coopers and the National Venture Capital Association using data from Thomson Reuters, says Essence Group Holdings Corporation was one of six St. Louis companies to complete fund-raising during the quarter. Venture capital firms invested $78.5 million in St. Louis companies during the third quarter, the largest amount in nearly three years, but 90 percent of the money went to Lumeris.
KevinMD.com Article: How to achieve the Triple Aim plus physician satisfaction// posted by Lumeris
Director of Innovation Research at Lumeris Dr. Tom Doerr shares strategies for reducing primary care physician frustration in a contributed article, “How to achieve the Triple Aim plus physician satisfaction” posted to KevinMD.com
Site Selection Magazine Article: Texas Wide Open for Business// posted by Lumeris
Lumeris was mentioned in Site Selection Magazine’s annual “Texas Wide Open for Business” issue. The article cites Lumeris’ Austin innovation center and quotes Mike Long and John Doerr.
Financial Buzz Article: Booming Digital Health Startups Surpass Total 2013 Investments// posted by Lumeris
Lumeris’ capital raise of $71 million is featured as part of the “enormously successful year” in the $2.2 billion invested in the digital health industry (as reported by Rock Health) in just the first half of 2014, which has already surpassed all of 2013.
The VAR Guy Article: Digital Health Startups Surpass 2013 Funding with $2.3B in 2014// posted by Lumeris
Lumeris is referenced as one of the top examples of the digital health funding uptick.
PFHub Article: Apple (AAPL) iWatch may have finger on the market’s pulse after all// posted by Lumeris
Apple’s iWatch is just part of the health care market’s interest in the future of digital delivery. The industry in just the first half of 2014 has seen $2.3 billion in private investment, and Lumeris’ capital raise of $71 million is featured as part of that investment. According to the article, the “funding frenzy” in 2014 could end up being a 200% increase over 2013.
Re/Code Article: Digital Health Investments in the First Half Surpass All of 2013// posted by Lumeris
Lumeris’ private-equity funding of $71 million is highlighted as part of the venture funds pouring “more than $2.3 billion of investments in the sector during the first half of the year—already surpassing the 2013 total.”
SearchBusinessAnalytics Article: Adoption of Analytics in Healthcare Faces Hurdles// posted by Lumeris
Keith Blankenship, vice president of technical solutions, discusses the importance of integrating data and how Lumeris has been successful working with clients to make sure data is useful, meaningful and actionable. Mark Pitts, vice president of enterprise informatics, data and analytics, discusses how Highmark Health is working to automate internal processes based on centralized data functionality.
Lexology Article: Digital health investments rack up another impressive month in May// posted by Lumeris
Lumeris’ private-equity round of funding, $71 million, is demonstrated as part of the continued strength and interest of investors to fund innovations in health care.
Webinar: Health Plan Operations// posted by Lumeris
Essence Healthcare and Lumeris Healthcare Outcomes President and CEO Richard Jones reveals a definitive blueprint for value-based health plan operations and population health services.
Bloomberg BNA Article: States Making Progress on HIT Initiatives, Industry Officials Say// posted by Lumeris
Bloomberg Bureau of National Affairs (BNA) Reporter Nora Macaluso featured comments from Lumeris’ Keith Blankenship on HIEs. Macaluso covered the Lansing, Michigan conference Lumeris attended (sponsored by the Michigan Health Information Network) on June 4.
For The Record Article: Vendors Vent MU Frustrations// posted by Lumeris
Lumeris’ Anthony Gil talks with For the Record about the requirements for stage 2 meaningful use focused on the advancement of clinical processes, which includes more rigorous health information exchange, increased requirements for ePrescribing and the incorporation of laboratory data, electronic transmission of patient care summaries across multiple settings, and a focus on more patient-controlled data.
Health IT Outcomes Article: Are ACOs Actually Enhancing Care Coordination?// posted by Lumeris
Sandra Gomberg, chief operating officer at Aria Health, answers questions about how provider incentives, clinically-integrated data, a care management solution, and Lumeris’ ADSP is helping Aria advance its population health initiatives.
St. Louis Business Journal Article: Teaming up with Trinity: Ascension’s plan to dominate Michigan Market// posted by Lumeris
Tony Fortino, director of Accountable Care Solutions at Lumeris, is quoted about the importance of keeping patients healthier in order to make health care better and more affordable for organizations transforming and expanding in the new health care marketplace.
Webinar: Quality Management// posted by Lumeris
Payers, health systems and providers need to deliver high-quality, value-based care that generates better clinical, operational and patient outcomes. To learn how integrating both the strategic side and the tactical side of quality helps organizations drive continuous quality improvement and keep populations healthy, hear from Lumeris experts on the replay of the Quality Management webinar, hosted by Accountable Care News.
Forefront Magazine Article: Should You Join a Start Up?// posted by Lumeris
In Forefront Magazine, Susie Robinson, chief of human resources for Lumeris, explains why she exchanged a stable job at a big company for a rollercoaster ride with a new venture.
Medical Practice Insider Article: Mitigating the Downside of ACOs// posted by Lumeris
Tom Doerr, MD, director of innovation research at Lumeris, discusses challenges posed by the ACO model, and how physicians can avoid those challenges and free themselves up to focus on the risks that count for future satisfaction and success.
HealthITOutcomes Byline: Value-Based Care Success Through Quality Analytics and Incentives// posted by Lumeris
Vice President of Technical Solutions for Lumeris Keith Blankenship writes about the importance of having a complete view of a patient’s and population’s health status to improve care quality and lower costs in a HealthITOutcomes byline.
InformationWeek HealthCare Article: Accountable Care Success Requires Strong Health IT// posted by Lumeris
Jeff Smith, president of the Mid-Atlantic initiative for Lumeris, discusses the importance of integrating data across health care organizations with Alison Diana from InformationWeek HealthCare.
InsuranceNewsNet Article: Flourishing as a Collaborative Payer Model in Missouri// posted by Lumeris
Deborah Zimmerman, MD, chief medical officer for Lumeris, discusses the Accountable Delivery System Platform (ADSP)® with InsuranceNewsNet.
South Florida Hospital News and Healthcare Report Article: Baptist Health Florida selects Lumeris for value-based care initiatives// posted by Lumeris
Baptist Health South Florida, one of America’s largest and most visionary health care organizations, has selected Lumeris as its operations, technology and consulting partner for value-based care.
South Florida Business Journal Article: Baptist Health signs affordable care program with Florida Blue// posted by Lumeris
Baptist Health South Florida, one of America’s largest and most visionary health care organizations, has selected Lumeris as its operations, technology and consulting partner for value-based care.
News Release: Baptist Health South Florida Selects Lumeris For Value-Based Care Initiatives// posted by Lumeris
Baptist Health South Florida, one of America’s largest and most visionary health care organizations, has selected Lumeris as its operations, technology and consulting partner for value-based care.
Managed Care Outlook Article: Addressing Five Key Areas of Value-Based Care// posted by Lumeris
Managed Care Outlook’s March 2014 issue features a contributed article, “Addressing Five Key Areas of Value-Based Care” from Keith Blankenship, vice president of technical solutions at Lumeris.
Webinar: Enhanced Encounter// posted by Lumeris
Lumeris Director of Accountable Care Consulting Services Terri Bellmore discusses Enhancing the Provider/Patient Encounter to Optimize Payer Revenue in a webinar moderated by Accountable Care News.
Video: Lumeris Enables PHM, Simplifies Data// posted by Lumeris
Health IT Outcomes was at HIMSS14 in Orlando, speaking with some of health care's leading businesses and organizations. Deborah Robin, MD, MHCM, medical director at Lumeris, spoke about the role Lumeris is playing to help enable population health management while simplifying data. Dr. Robin also discusses the “journey” to value-based care and how Lumeris is helping providers better manage it.
Video: Accountable Primary Care Model Presented at HIMSS14// posted by Lumeris
At HIMSS14, Lumeris Medical Director Deborah Robin, MD, MHCM presented the Accountable Primary Care ModelSM or Nine C’sSM framework, which offers primary care providers workflows and behavioral strategies to transform from volume- to value-based care delivery.
Video: The Lumeris Accountable Delivery System Platform// posted by Lumeris
Lumeris Medical Director Deborah Robin, MD, MHCM spoke with Co-Founder of Health Innovation Media Pat Salber, MD, MBA about Lumeris and its Accountable Delivery System PlatformSM (ADSP)® at HIMSS14.
Photo: Lumeris Presents “Collaborative Payer Innovations Driving ROI in Value-Based Care” at HIMSS14// posted by Lumeris
Deborah W. Robin, MD, MHCM, medical director of Lumeris, and Dr. Edward Scanlan, medical director of Network Health, presented an educational session at the HIMSS14 Annual Conference in Orlando, Fla. on February 26. The session explored how collaborative payers are engaging and empowering providers to meet quality, cost and ...
Modern Healthcare Video: What Is Care Management// posted by Lumeris
Lumeris Medical Director Deborah Robin, MD, MHCM speaks with Christina Galoozis from Modern Healthcare Custom Media at HIMSS14 about what is care management and why it matters in today’s health care system.
News Release: Aria Health and Lumeris Team To Optimize Contract Performance// posted by Lumeris
Aria Health and Lumeris today announced a value-based initiative to improve the quality of care for nearly 20,000 Aria Health patients in Northeast Philadelphia
EHRIntelligence Article: What tools are needed for managing population health?// posted by Lumeris
IDC Health Insights’ Research Director Cynthia Burghard discusses three types of tools – analytics, workflow and communication - needed to be successful in accountable care.
News Release: Lumeris to Present Insights on Collaborative Payer Innovations at HIMSS14// posted by Keith Blankenship
Lumeris today announced that Debra Gribble, executive vice president of Lumeris and Essence Healthcare, and Dr. Edward Scanlan, medical director of Network Health, have been selected to lead a roundtable presentation during the HIMSS14 Annual Conference in Orlando, Fla.
HISTalk Article: Monday morning update round-up// posted by Lumeris
Jim Hansen, vice president of health policy for Lumeris, offers commentary at a recent HIT Policy Committee meeting.
ACOWatch Blogtalk Radio: An ACO Roundtable on ‘Early Results’// posted by Lumeris
Jim Hansen, vice president of health policy for Lumeris participated in an ACO roundtable on early MSSP ACO results on “This Week in Accountable Care” with host Gregg Masters.
Healthcare Informatics Article: Data Revolution: When Claims and Clinical Data Meet// posted by Lumeris
Keith Blankenship, vice president of technical solutions for Lumeris, spoke with Healthcare Informatics about the importance of integrating EMR and claims/cost data for population health management.
Healthcare Informatics Article: Flourishing As a Collaborative Payer Model in Missouri// posted by Lumeris
As reimbursement cuts and other payment changes put intensifying pressure on physicians and medical groups, accountable care offers new opportunities for collaboration between payers and providers. In Missouri, Esse Health—a group of about 70 primary care physicians in the St. Louis area—started Essence Healthcare in 2004, an insurer that offers coverage under the Medicare Advantage program, serving more than 40,000 members. Essence Healthcare provides its network of providers a collaborative payer model.
FierceHealthIT Article: Population Health Tools Essential to ACO Success// posted by Lumeris
Applications for population health management that integrate claims and clinical data can provide the insights essential to the success of accountable care organizations (ACOs), according a new report from IDC Health Insights.
Clinical Innovation+Technology Article: ACOs Require More than EMRs to Manage Population Health// posted by Lumeris
While EMRs provide accountable care organizations (ACOs) with data critical for population health management, additional health IT tools that integrate patient data from multiple sources, support the management of care plans and enable patient communications are required as well, according to a report from Mass.-based research firm IDC Health Insights.
EHR Intelligence Article: Accountable Care Requires More Health IT than Just EHRs// posted by Lumeris
Meeting the goals of accountable care and achieving the associated cost reductions requires a more robust health IT infrastructure than just an electronic health record can provide, says a report by IDC Health Insights. The triple aim of improving the patient experience, improving population health, and slashing system-wide costs can only be realized when healthcare organizations incorporate advanced technology and embrace the principles of value-based healthcare that provides the foundation for accountable care organizations (ACOs).
Becker’s Hospital Review Article: 11 Technologies ACOs Need// posted by Lumeris
In order to effectively manage population health, accountable care organizations’ technology needs go far beyond electronic health systems. A recent IDC spotlight has identified the IT systems and technological abilities ACOs need to effectively monitor the health of a population.
News Release: New Research Sponsored by Lumeris Defines Requirements for Population Health Management// posted by Lumeris
Lumeris will host a free webinar where IDC Health Insights Research Director Cynthia Burghard will present key trends from the market and discuss the new IDC Health Insights’ Accountable Care Maturity Model.
Health Data Management Article: Report: Tech Needs by ACOs Go Way Beyond EHRs// posted by Lumeris
A new report from research firm IDC Health Insights examines the information technology needs of accountable care organizations beyond an electronic health records system.
Health Management Technology Article: Preventing Clinical Data Exhaust Streams// posted by Lumeris
A new report from research firm IDC Health Insights examines the information technology needs of accountable care organizations beyond an electronic health records system.
FoxBusiness.com Article: Health Trends to Watch for in 2014// posted by Lumeris
If 2013 was all about preparing for the launch of the health-care exchanges, the new year will undoubtedly be about navigating them. But the health reform isn’t the only change coming to the industry in 2014. From increased access to health information to technology playing a larger role in your health, here’s a look at trends consumers will likely see next year.
Medical Practice Insider Article: Why MU Extension is Failing Physicians// posted by Lumeris
The industry seemed to sigh in relief when the Centers for Medicare & Medicaid Services (CMS), alongside the Office of the National Coordinator for Health IT (ONC), extended meaningful use Stages 2 and 3 earlier this month. But aside from a bit of breathing room, some experts are saying that the move doesn’t really offer much else. "The extension in my opinion will not greatly impact adoption trends,” Keith Blankenship, vice president of technical solutions for Lumeris, an accountable care delivery innovation company, told Medical Practice Insider. According to Blankenship, the extension was not designed with provider adoption in mind.
Becker’s Hospital Review Article: 5 Predictions for Value-Based Care in 2014// posted by Lumeris
The transition from fee-for-service to value-based care is top of mind for many healthcare organizations as their leadership prepares for 2014. Value-based care, an umbrella term encompassing ideas including accountable care, population health and financial incentives for outcomes, will eventually be the norm for healthcare delivery and reimbursement. For the many organizations shifting to these models, Lumeris, an accountable care innovation company, offers five predictions for value-based care in 2014.
Photo: L. John Doerr Visits Lumeris// posted by Lumeris
L. John Doerr, Partner, Kleiner Perkins Caufield & Byers and Lumeris board member shares his philosophy about Objectives and Key Results with Lumeris Senior Managers on December 18, 2013.
Healthcare Payer News Article: Easing into Risk Adjustment, Shared Savings// posted by Lumeris
Medicare Advantage has been using a risk adjustment payment formula since 2007, and now a similar approach is coming to insurance exchange markets. The Department of Health and Human Services estimates that $45 billion in risk adjustment transfers will be needed between 2014 and 2017 for health plans in insurance exchange, to compensate for cost volatility from new members. The Medicare Advantage risk adjustment formula, based on hierarchical condition categories from ICD codes and demographic factors, should transition smoothly to the commercial market, said Dave Corrigan, informatics director at technology and consulting company Lumeris. “Obviously the conditions that go into the model in the commercial population are going to be different, but the model is the same,” Corrigan said.
Healthcare Technology Online Article: The Value of Integrating EMR and Claims/Cost Data in the Transition to Population Health Management// posted by Lumeris
A byline by Jim Hansen, vice president of health policy for Lumeris covers the transition to accountable care and how adding claims/cost to EMR data enables informed value-based decisions by offering a complete view of a patient’s health care history. With this view, providers become true population health managers with the power to achieve better health outcomes, lower costs and improved patient plus physician satisfaction.
News Release: Lumeris Releases Five Predictions for Value-Based Care in 2014// posted by Lumeris
ST. LOUIS — December 10, 2013 — Recently, health economists and policy experts have started crediting innovations spurred by the Affordable Care Act (ACA) for the decline in the rate of health care spending. With more than 500 accountable care organizations (ACOs) in the United States today, and nearly ...
Webinar: Automated Reporting – Enabling Value-Based Decisions// posted by Lumeris
The Lumeris solution for Automated Reporting gives health systems and health plans the tools they need to use data to make value-based decisions.
InformationWeek Healthcare Article: Patient Discharge Plans Move Out Of The Hospital// posted by Lumeris
When a patient is discharged from the hospital, they're not in an ideal position to receive medical information about their discharge plan. They can be medicated or confused, or even try to rush the process to get out of the hospital as soon as they can. Hospitals and vendors are developing technology to bridge this gap in care. With a shifting payment model in healthcare, keeping patients out of the hospital is more important than ever before, and successful communication of discharge plans can help achieve that goal. "The focus on this issue began when hospitals started being penalized for high readmission rates," said Dr. Deborah Robin, medical director at Lumeris, a care management firm. "That got everyone's attention and people started to come up with technology solutions."
Health Management Technology Article: Making Clinical Data Analytics Count// posted by Lumeris
Lumeris Director of Product Management Eric Mueller discusses how to leverage clinical data analytics to make more informed health care decisions.
Accountable Care News Bulletin Article: New Hope for Primary Care: The Accountable Primary Care Model// posted by Lumeris
Lumeris via YouTube: Tom Doerr, MD, Director of Innovation Research at Lumeris and Deborah W. Robin, MD, MHCM, Medical Director at Lumeris, present at a National Accountable Care Congress (ACO) Breakout Session. Dr. Robin discusses the premises and five key elements of success for ACOs. Dr. Doerr shares some of the outcomes of accountable care practices and provides a walk-through of the accountable care model.
Healthshare TV Video: New Hope for Primary Care: The Accountable Primary Care Model// posted by Lumeris
Tom Doerr, MD, Director of Innovation Research at Lumeris and Deborah W. Robin, MD, MHCM, Medical Director at Lumeris, present at the 4th National Accountable Care Organization Congress.
News Release: Lumeris to Present at AHIP’s Operations and Technology Forum// posted by Lumeris
Session Will Explore Collaborative Payer-Provider Strategy and Tools for Transforming Practice Operations to Support New Business and Care Delivery Models.
ACOWatch Article: The Accountable Primary Care ACO// posted by Lumeris
Gregg Masters attended the 4th National Accountable Care Organization Congress and wrote a blog post about the session, “New Hope for Primary Care: The Accountable Primary Care Model” by Tom Doerr, MD, Director of Innovation Research, and Deborah W. Robin, MD, MHCM, Medical Director.
Webinar: Care Management – Better Care at Lower Cost for People with Multiple Health and Social Needs// posted by Lumeris
Lumeris’ care management webinar 'Better Care at Lower Cost for People with Multiple Health and Social Needs' is now online.
Video: New Hope for Primary Care: The Accountable Primary Care Model// posted by Lumeris
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.
Managed Care Contracting & Reimbursement Advisor Article: CMS Might Pay for Telehealth, Chronic Care Without Visit// posted by Lumeris
It might be a move in the right direction, or it could be a significant change in how the physician fee schedule encourages certain types of care—we won’t know until later—but right now it’s encouraging that CMS is considering paying primary care physicians for chronic care management services without an in-person visit, and also for telehealth services. “I think primary care physicians are going to see a tsunami of patients wanting care and newly insured in 2014, and this is one of the easier ways to expand capacity,” said Tom Doerr, MD. “You don’t have to take on the hiring of a new midlevel clinician. There is a lot less stress involved with just sending an email and getting reimbursed for it.”
HealthLeaders Article: CMS might pay for telehealth, chronic care without visit// posted by Lumeris
“Improved reimbursement for telehealth is long overdue, says Tom Doerr, MD, a physician in St. Louis who specializes in geriatrics and regularly communicates with patients by email. “By and large it’s not been embraced, and this is a terrific opportunity to expand our work in light of the shortage of physicians,” Doerr says. “We can increase our capacity and still do it well.” He notes that Group Health Cooperative in Seattle used emails for six years and found that 30% of outpatient encounters are now done by email. “I think primary care physicians are going to see a tsunami of patients wanting care and newly insured in 2014, and this is one of the easier ways to expand capacity,” Doerr says. “You don’t have to take on the hiring of a new midlevel clinician. There is a lot less stress involved with just sending an email and getting reimbursed for it.”
Video: Health 2.0 Presentation: Big Data Tools for Population Health Management// posted by Lumeris
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)®.
Becker’s Hospital Review Article: The Affordable Care Act and Physicians: A Prescription for Change// posted by Lumeris
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.
Video: Collaborative Risk Adjustment and Care Coordination for Medicare Advantage and Dual Eligibles// posted by Lumeris
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 ...
HIEWatch Article: Data Integration As The First Step// posted by Lumeris
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.
Group Practice Journal Article: Toward a Value-Based Model “Nine C’s” Map the Way// posted by Lumeris
A byline by Tom Doerr, MD, director of innovation research for Lumeris covers why providers, health systems and payers must learn new skills and best practices for improving population health management.
CA Technologies Article: Lumeris Retains Control of Investments and Optimizes Resources During Rapid Growth with CA Clarity PPM// posted by Lumeris
Transforming the US health care market, Lumeris' innovative solutions help health care organizations design, build, operate, measure, and optimize any accountable care model.
News Release: Lumeris to Present at AHIP’s 2013 Medicare and Medicaid Conference// posted by Lumeris
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 Plans ...
Healthcare Finance News Article: Docs Skeptical Of Value-Based Care// posted by Lumeris
Doctors are told that the value-based care model will allow them to foster closer relationships with their patients, have greater access to clinical and pricing data and let them see fewer patients but earn more money. Value-based care sounds like a physician’s dream come true, but many are not enthusiastic about it. Physicians took personal financial risks for the managed care model and many got burned when the model collapsed, said Tom Doerr, a primary care physician practicing geriatric medicine in St. Louis who co-founded Lumeris, an accountable care solutions company.
Executive Insight Article: Strategies to Identify the ROI of an ACO// posted by Lumeris
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.
Health Management Technology Article: Guest Blog: Mostashari’s Departure Leaves Big Shoes to Fill// posted by Lumeris
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.
MedCity News Article: ACOs by the Numbers: Where Are We Now?// posted by Lumeris
Now that accountable care organizations as spelled out in the PPACA are growing out of the infancy stage, and CMS has delivered performance data from the first year of the Pioneer ACO Model, the healthcare industry is starting to see some clarity in the overall ACO movement. Leavitt Partners, a research firm that has been tracking the growth of accountable care organizations since 2010, spelled out its observations in a new report, “Growth and Dispersion of ACOs: August 2013 Update” (PDF). Here are some of the main takeaways, by the numbers.
Becker’s Hospital Review Article: 100 Accountable Care Organizations to Know// posted by Lumeris
A significant number of accountable care organizations have formed since this publication's 2012 list of "80 Accountable Care Organizations to Know," and there were some noteworthy developments from existing ACOs.
Business Week Article: Health Care Was Innovating Before Obamacare// posted by Lumeris
It’s not often I take issue with Thomas L. Friedman, the New York Times’s three-time Pulitzer Prize-winning columnist. But a recent column leaves the mistaken impression that the 2009 federal stimulus bill and the 2010 Affordable Care Act are the driving forces behind recent innovations in health care, particularly in the area of information technology (IT). As evidence, Friedman points to the large number of startups—such as Eviti, Humedica, Lumeris and Teladoc—that have opened their doors in the past couple of years to tap into health care’s growing electronic information market.
Becker’s Hospital Review Article: Nine Fewer Pioneer ACOs: Healthcare Experts on What This Means for Accountable Care// posted by Lumeris
After releasing the first-year results from its Medicare Pioneer Accountable Care Organization Model, CMS confirmed Tuesday that nine Pioneer ACOs would exit the program, with seven planning to join the Medicare Shared Savings Program and two exiting the Medicare ACO program completely. Here, healthcare experts give their take on why the organization are leaving the Pioneer program and what that means for accountable care efforts as a whole.
This Week in Accountable Care Article: The Pioneer ACO Results Are In// posted by Lumeris
Jim Hansen, VP of Lumeris 's Accountable Delivery System Institute and Dr Jerry Penso Chief Medical and Quality Officer the American Medical Group Associaton (AMGA) discuss the recent announcement by the Centers for Medicare and Medicaid of the results from the first year of participation in the Pioneer ACO program.
Physicians Practice Article: Nine Steps to Accountable Patient Care// posted by Lumeris
Lumeris' Tom Doerr, MD and Debra Zimmerman, MD speak to Physician Practice on background about the Nine C’s/steps to value-based care.
Healthcare Payer News Article: ACO makes payer an ally of provider// posted by Lumeris
By John Andrews, Healthcare Payer News - “Medical Home” is another moniker associated with the ACO concept and while some see them as interchangeable, Tom Doerr, MD, does not. A general internal medicine practitioner who focuses on geriatric patients, Doerr also serves as director of innovation research for St. Louis-based Lumeris.
PhysBizTech Article: ACOs Strike it Hot in Healthcare// posted by Lumeris
The hottest letters in healthcare right now are A, C and O. And while together they stand for accountable care organization, industry analysts say providers need to look beyond the acronym in their efforts to build a new business model. "Medical home” is another moniker associated with the ACO concept and while some see them as interchangeable, Tom Doerr, MD, does not. A general internal medicine practitioner who focuses on geriatric patients, Doerr also serves as director of innovation research for St. Louis-based Lumeris.
Government Health IT Article: Why Do Docs Struggle with Population Health Data?// posted by Lumeris
By Anthony Brino, Associate Editor, Government Health IT - "You have to see a much bigger picture — quality metrics, cost and utilization metrics, and those things are typically not reported in an EMR," said Deborah Robin, MD, medical director at the accountable care technology company Lumeris and a geriatrician and rheumatologist who spent 24 years working in research and teaching at Vanderbilt University Medical Center.
Reuters: Better Healthcare for Less Money, If You Can Find It// posted by Lumeris
Consumers intrigued by the new model of accountable healthcare - which promises better-coordinated care that could save lots of money - are going to have to actively seek out participating providers.Yet, there is some evidence that just encouraging more active patient involvement lowers their costs. Studies by Judith Hibbard, a professor of health policy at the University of Oregon, show that patients who are actively engaged in their own care have achieved costs savings of 8 to 21 percent. Jim Hansen, vice president of the Accountable Delivery System Institute of Lumeris, which provides the technological backbone for Essence Healthcare (and is owned by the same private holding company Essence Group Holdings Corp), says that the groups with which he deals are considering incentives and bonuses like gift cards for patients who make cost-saving decisions.
Becker’s Hospital Review Article: Nine Steps to Build an Accountable Primary Care Model// posted by Lumeris
Here, Dr. Doerr shares more in-depth information on all nine parts of the Accountable Primary Care Model, how physicians can achieve success at each step of the transformation process and how the Nine C's can help physicians accomplish the "Triple Aim Plus One."
This Week in Accountable Care Article: This Week in Accountable Care with Tom Doerr, MD// posted by Lumeris
InformationWeek Article: Will Doctors ‘C’ The Way To Accountable Care?// posted by Lumeris
Health IT vendor Lumeris develops "Nine C's" framework to help primary care physicians achieve healthcare reform goals.
HIEWatch Article: IBC, Abington Health pen accountable care pact// posted by Lumeris
By Anthony Brino, editor of HIEWatch - An accountable care initiative comprising Philadelphia-based insurer Independence Blue Cross, local provider group Abington Health and St. Louis-based tech firm Lumeris, will be among the first of its kind in greater Philadelphia, with doctors having a 360-degree view of a patient’s care across specialists and physicians, hospitals and clinics from all networks.
News Release: Lumeris Executives Spotlight Accountable Care at Premiere Industry Events// posted by Lumeris
CEO Michael Long to Discuss Health Information Exchange at ACO Summit Medical Director Deborah Robin Provides Collaborative Payer Model Overview at AHIP
Best’s News Service Article: Lumeris Medical Chief: Move From Fee-for-Service to Population Health Management for ACOs to Succeed// posted by Lumeris
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.
SearchHealthIT Article: Where HIE, Physician Practices and ACO Data Analytics Meet// posted by Lumeris
While many pundits, analysts and media observers may harbor opinions on how U.S. healthcare will build the accountable care organization model, few parties can be considered actual stakeholders in the process. Tom Doerr, M.D., Lumeris' director of innovation research, is one such stakeholder. Not only is he a practicing geriatric internist in St. Louis, but he's also the brother and business associate of legendary tech venture capitalist John Doerr. His practice and his investment strategy both hinge upon successful accountable care organization (ACO) rollouts. In this podcast, we get his vision of how ACO data analytics will drive new payment models in U.S. healthcare -- and how he puts it to work every day.
eWeek Article: Obamacare, Open Data Could Drive Health IT Innovation// posted by Lumeris
Although many companies have yet to fully implement the Affordable Care Act, the law known as Obamacare could drive an increase in new health IT startups and innovation.Software company Lumeris (formerly ClearPractice) offers the Accountable Delivery System Platform (ADSP)® to provide a view of population health and analyze data across a care continuum, including medical claims, electronic health records (EHRs), data from patient visits, as well as lab and pharmacy data.
New York Times Article: Obamacare’s Other Surprise// posted by Lumeris
LISTENING to the debate about President Obama’s health care plan, some critics argue that Obamacare is going to need Obamacare — because it’s going to be a “train wreck.” Obama officials insist they’re wrong. We’ll just have to wait and see whether the Affordable Care Act, as the health care law is officially known, surprises us on the downside. But there is one area where the law already appears to be surprising on the upside. And that is the number of health care information start-ups it’s spurring. This is a big deal.
Healthcare IT News Article: Nine C’s Part Two: The Back End// posted by Debbie Zimmerman, MD
As Deborah Zimmerman, MD, chief medical information officer at Lumeris, described it, "The nine C’s are about the need to change care delivery and business delivery." In other words, successfully reforming healthcare means moving to an accountable care delivery system, not just accountable care.
Healthcare IT News Article: Nine C’s Lead to Accountable Care// posted by Debbie Zimmerman, MD
Deborah Zimmerman, MD, CMIO at Lumeris, says one of the questions that the operations, technology and services solutions company has recently been focusing on is, “What are those characteristics that a physician needs to have in order to deliver accountable care?”
Becker’s Hospital Review: Financial Modeling: Predictive Insight Into Value-Based Care Success// posted by Lumeris
Since the Patient Protection and Affordable Care Act passed in 2010, healthcare provider organizations have explored sharing in cost savings with other providers and/or payors and taking on risk through accountable care organizations and other value-based care models. While the ACO model has flourished as of late, many hospitals and health systems are still reluctant to join the movement. In fact, 75 percent of hospitals polled by the Commonwealth Fund were not considering ACO participation at all, according to a report published in August 2012. The hesitancy is understandable: Accountable care is a threat to traditional hospital and health system revenue streams. But Eric Olmsted, PhD, director of analytic consulting for Lumeris, a healthcare technology firm, says not participating in the new care delivery model may be even worse.
InformationWeek: Will Doctors ‘C’ the Way To Accountable Care?// posted by Lumeris
A technology company focused on health system transformation has introduced a new framework meant to serve as a how-to guide of sorts for physicians to become providers of accountable care. The Accountable Primary Care Model, from Maryland Heights, Mo.-based Lumeris, incorporates a series of concepts and steps called the Nine C's to help physicians achieve what Lumeris calls the "Triple Aim Plus One."
SearchHealthIT Article: Payers, Providers Must Share Data to Improve Quality of Care// posted by Lumeris
Lumeris' Debra Zimmerman discusses how payers and providers are going to have to align incentives and share relevant data to improve both quality and cost of care, at the 10th Annual World Health Care Congress in National Harbor, Md.
News Release: Lumeris unveils Accountable Primary Care Model to speed adoption of value-based care and meet the “triple aim plus one”// posted by Lumeris
Nine C’s framework offers primary care providers workflows and behavioral strategies to transform from volume- to value-based care delivery
PhysBizTech Article: 5 Ways ACOs Benefit From Health IT// posted by Lumeris
As accountable care organizations spring up, more institutions will be communicating with each other to deliver and be reimbursed for care that is judged by its quality. Doing this will be a challenge, as multiple hospitals and practices team up with and talk with myriad payers.
Healthcare IT News Article: 5 Ways ACOs Benefit From Health IT// posted by Lumeris
As accountable care organizations spring up, more institutions will be communicating with each other to deliver and be reimbursed for care that is judged by its quality. Doing this will be a challenge, as multiple hospitals and practices team up with and talk with myriad payers. Leveraging health IT to streamline and improve those communications will not only make it easier for all involved, but could be a crucial element to staying afloat and delivering the best possible levels of care. Steve Bethke, vice president of product management at Lumeris, a provider of operations, technology and consulting services to ACOs.
Healthcare Payer News Article: ACOs Doomed to Fail?// posted by Lumeris
Accountable care organizations might be today's hope for grappling with healthcare costs and bumping up quality, but according to one expert, they are doomed to fail without one key element. Without systemic changes – the desire to change the way healthcare is delivered – an ACO is most likely doomed to failure, says Jim Hansen, vice president of the Accountable Delivery System Institute for Lumeris, a St. Louis, Mo.-based company that offers technology and service solutions for accountable care models. “If all you’re doing is signing a contract, you really aren’t going to garner the kinds of benefits that everyone’s expecting at that level,” Hansen says of today’s ACO model.
Government Health IT Article: What ACOs Must Do to Succeed?// posted by Lumeris
Accountable care organizations might be today’s hope for grappling with healthcare costs and bumping up quality, but according to one expert, they are doomed to fail without one key element. Without systemic changes – the desire to change the way healthcare is delivered – an ACO is most likely doomed to failure, says Jim Hansen, vice president of the Accountable Delivery System Institute for Lumeris, a St. Louis, Mo.-based company that offers technology and service solutions for accountable care models.
News Release: Lumeris Enhances Care Management Capabilities in Transformational Accountable Delivery System Platform// posted by Lumeris
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.
Healthcare Finance News Article: IBC, Abington Health Pen Accountable Care Pact// posted by Lumeris
An accountable care initiative comprising Philadelphia-based insurer Independence Blue Cross, local provider group Abington Health and St. Louis-based tech firm Lumeris, will be among the first of its kind in greater Philadelphia, with doctors having a 360-degree view of a patient’s care across specialists and physicians, hospitals and clinics from all networks.
FoxBusiness.com Article: Accountable Health Care: Shifting the Focus to Prevention// posted by Lumeris
In today’s health-care system, a doctor’s main job is to diagnose and treat patients’ ailments, but in the future, their focus will shift to prevention. Accountable health care is the idea that your doctor is responsible for keeping you healthy, and the trend is gaining momentum as a way to keep rising health-care costs under control. "Accountable health care matters to consumers because it is the best hope of bringing health care spending into alignment,” says Mike Long, chief executive of Lumeris, a healthcare technology company. “Accountable care organizations, which are formed when payers, providers and health systems work together on behalf of the patient, are focused on driving down cost, improving quality outcomes and enhancing patient and physician satisfaction."
Healthcare Payer News Article: IBC, Abington Health, Lumeris launch accountable care initiative// posted by Lumeris
An accountable care initiative comprising Philadelphia-based insurer Independence Blue Cross, local provider group Abington Health and St. Lous-based tech firm Lumeris, will be among the first of its kind in greater Philadelphia, with doctors having a 360-degree view of a patient’s care across specialists and physicians, hospitals and clinics from all networks.
News Release: Independence Blue Cross, Abington Health, Lumeris Create Cutting-Edge Accountable Care Initiative to Improve Quality, Lower Costs, Increase Satisfaction// posted by Lumeris
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 Lumeris
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 Lumeris
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.
iHealthBeat Article: Lumeris CEO Talks About the Future of Accountable Healthcare Delivery Systems in Health 2.0 Interview// posted by Lumeris
One of the most enjoyable interviews of the Health 2.0 Conference in San Francisco this week was that of Michael Long, Chairman and CEO of Lumeris. He was interviewed by Jane Sarasohn-Kahn of iHealthBeat. Michael is also the CEO of Essence Group Holding Company, and many will also recognize his name as the former CEO of Healtheon Corporation (now WebMD).
News Release: Lumeris establishing technology innovation center in Austin// posted by Lumeris
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.
Clinical Innovation Article: Health plans partner with Lumeris to purchase NaviNet// posted by Lumeris
Insurance & Technology Article: Horizon, Highmark, Independence Blue Cross Acquire NaviNet// posted by Lumeris
The health insurers partnered with health IT company Lumeris to buy the health communication network.
Healthcare IT News Article: NaviNet to be acquired by Lumeris, Blues// posted by Lumeris
In a deal that aims to create a technology company focused on providing real-time data to doctors from both medical records and private payers, Lumeris and payers Highmark Inc., Horizon Blue Cross Blue Shield of New Jersey and Independence Blue Cross announced they will acquire NaviNet for an undisclosed price.
Trib Live Article: Highmark, partners acquire Boston networking company// posted by Lumeris
Highmark Inc., two other Blue Cross companies and a St. Louis technology company have partnered to acquire a Boston company that provides that nation's largest communication network for physicians, hospitals and health insurers. Highmark and the other companies have agreed to buy NaviNet Inc. for an undisclosed price, according to a news release from NaviNet.
The New York Times Bits Article : John Doerr’s Patient Health Care Start-Up Gains Momentum// posted by Lumeris
Remember Healtheon, the dot-com company that was going to bring the hidebound health care industry into the Internet era? Well, it didn’t work out that way, and the best-known remnant is WebMD, a Web site for health information and news. “We had the right idea, and it was a serious effort,” recalled W. Michael Long, former chief executive of Healtheon. “But it was disappointing.”
News Release: Blues Plans, Lumeris Partner to Acquire Nation’s Largest Real-Time Health Care Communication Network// posted by Lumeris
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 Lumeris
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 Lumeris
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 Lumeris
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 Lumeris
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 Lumeris
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 Lumeris
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 Lumeris
Lumeris today announced Blue Cross and Blue Shield of Florida, Inc., (BCBSF) has implemented the company’s innovative Accountable Delivery System Platform (ADSP)® to help lower costs and enhance the quality of health care delivered to BCBSF Medicare Advantage enrollees in southern Florida.
Blog: Moving From Volume- To Value-Based Care: Best Practices in Population Health Management// posted by Carol Murdock
Senior vice president and head of markets, Carol Murdock, shares insights on how other organizations work to make accountable care a reality.
Blog: A CEO’s Reflection: Why the Lumeris Collaborative Model Works for Providers, Patients and Payers// posted by Mike Long
Essence Healthcare, Lumeris' pioneer client, has just received an extraordinary rating from the Centers for Medicare and Medicaid Services (CMS), 5-Stars, for the quality of services it delivers to its Medicare Advantage (MA) members, placing it in the 98th percentile of all MA plans.
Guest Blog: Experience Matters when Addressing the Challenges of Population Health Management// posted by Keith Blankenship
For years, vendors in the population health management space have been pushing technology as the solution to the inefficiency of the healthcare system. Many people believed that if you could gather the data and integrate it together, you could improve quality, cut costs and make everyone happy. But, we are now at a point where we see that technology alone is not the answer.
Guest Blog: Lumeris’ Population Health Effectiveness: Essence Healthcare Achieves 4.5-Star Rating// posted by Martha Butler
Since our formation more than a decade ago by a group of local doctors, Essence Healthcare has worked side by side with doctors to provide comprehensive and affordable health insurance to over 40,000 people with Medicare in Missouri and southern Illinois. We are honored to receive the 4.5 star rating for a fourth year in a row.
Guest Blog Series: Part 3: How The Nine C’s Help Accountable Providers Engage Accountable Consumers// posted by Tom Doerr
With increasing responsibility for their own care, consumers are realizing the importance of their providers and care teams. And, in the age of the Affordable Care Act, more and more previously uninsured patients are realizing how vital it is to manage their own health care to keep costs manageable.
Guest Blog Series: Part 2: How The Nine C’s Help Accountable Providers Engage Accountable Consumers// posted by Tom Doerr
Providers moving toward a value-based care system are finding success in engaging patients by applying the best-practice experience from primary care physicians (PCPs), as summarized in Lumeris’ Accountable Primary CareSM Model, also known as the Nine C’s®.
Guest Blog Series: Part 1: How The Nine C’s Help Accountable Providers Engage Accountable Consumers// posted by Tom Doerr
As consumers begin to accept accountability for their health, payers and providers have the opportunity to build trust and improve their experience and engagement. Equipped with new tools and information to compare costs and coordinate care, accountable physicians have financial incentives to deliver better quality care and lower costs.
Point of View: Consumer Engagement// posted by Lumeris
As providers assume greater risk from payers, they are requesting accountability from consumers. But, how do providers engage and empower consumers to make educated health choices and become partners in their own health care? In this point of view, Lumeris offers five, interrelated strategies, based on 10 years of value-based care experience, to help guide accountable providers to successfully engage patients for better clinical and financial outcomes.
Point of View: Health Plan Operations and Population Health Services// posted by Lumeris
A definitive blueprint for value-based health plan operations and population health services revealed. Using 10 years of health plan, multi-payer and value-based care experience, Lumeris developed a four-part framework to significantly improve value-based health plan operations. The model includes identifying improvement opportunities to address business transformation, structuring the organization and implementing change, offering value-based care services that support office management and population health, and optimizing business processes. This essential guidance supports business and care delivery transformation in pursuit of the Triple Aim Plus One: better health outcomes, lower costs and improved patient plus physician satisfaction.
Guest Blog: Improving Quality through Patient and Provider Outreach// posted by Lumeris
Providers can become true managers of quality—and earn bonuses as part of value-based contracts—by making full use of data to close gaps in care as well as data transparency to benchmark their performance against their provider group and national peers. At Lumeris, our powerful technology solutions provide market differentiation for health systems and payers, especially in equipping their network of providers with the ability to stratify patients and populations for improved quality performance.
Guest Blog: Integrating Quality Management in Value-Based Contracts// posted by S. Troy McMullin
How does an investment in quality deliver value for health systems, payers, providers, and patients? From government-led ACOs to commercial contracts, successful quality management begins with strategic assessments that pinpoint where to focus improvement efforts. At Lumeris, our proven approach optimizes quality metrics in any value-based care model.
Guest Blog: Advancing Clinical Performance with Strategic Quality Management// posted by John Khoury
Delivering high-quality care is essential to succeeding in today’s evolving market. Well-chosen quality metrics and effective incentives in value-based contracts can lead to healthier populations by generating better clinical, operational and patient outcomes. Lumeris simplifies quality management for health systems, payers and providers.
Point of View: Quality Management// posted by Lumeris
Quality Management: Empowering Payers, Health Systems and Providers to Achieve Optimal Health Outcomes.
Guest Blog: Success Managing Risk and Revenue with Prospective Health Assessments// posted by Terri Bellmore
As the October 1, 2014 date for the conversion of the medical coding system from ICD-9 to ICD-10 grows closer, pressure is increasing for coders and physicians to quickly understand, implement and use the system.
Point of View: Enhancing The Provider/Patient Encounter To Optimize Payer Revenue// posted by Lumeris
To optimize risk-adjusted revenue for payers, and increase the quality of care each patient receives, Lumeris offers the Enhanced Encounter® Solution, built upon its expertise in meeting the goals of Triple Aim Plus One: better health outcomes, lower costs and improved patient –and our plus one – physician satisfaction.
Guest Blog: Sophomore to Freshman MSSPs: “Ready…Fire…Aim” Not a Good ACO Data Strategy// posted by Lumeris
“The early lesson is that data is what makes [accountable care] possible.” Elliot Fisher, M.D., Dartmouth Institute for Health Policy and Clinical Practice As we begin to absorb the public results announcements and comments for CMS MSSP entities that have been operating for over a year, and for ...
Point of View: The Value of Integrating EMR and Claims/Cost Data in the Transition to Population Health Management// posted by Lumeris
The Value of Integrating EMR and Claims/Cost Data in the Transition to Population Health Management
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.
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 Lumeris
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.
ADSI Blog: Accountable Care 2.0: It’s a Journey, Not a Program// posted by Lumeris
CMS released a long-awaited checkpoint status on its Pioneer ACO program. Of the 32 entities enrolled in the program, according to CMS...
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.
Blog: Health Information Exchange Revisited// posted by Mike 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 ...
ADSI Blog: What is the Future State Vision for Health Care Delivery System Transformation?// posted by Lumeris
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?
Blog: Are Happier Physicians the Answer to Our Health Care Dilemma?// posted by Mike Long
I have used the last two blog posts to introduce the Accountable Primary CareSM Model*, or the NineSM 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 ...
Blog: Accountable Care Doesn’t Require Changing Physician Behavior!// posted by Mike 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 ...
ADSI Blog: The Key to Getting Real Results from Accountable Care Initiatives: Do it Right or Don’t Do it at All// posted by Lumeris
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?
Blog: Accountable Primary Care: What Can We Learn From Golf?// posted by Mike 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. ...
Blog: What Does a Practicing Accountable Physician Look Like? Do They Behave Differently?// posted by Mike 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 ...
Blog: Keeping Doctors at the Center of Health Care// posted by Mike 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 ...
Blog: It’s Time!// posted by Mike 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 ...
ADSI Blog: Accountable care 2.0 offers promise of success beyond today’s accountable care 1.0 maturity level approach// posted by Lumeris
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.
Blog: Accountable Care: A Cost-Control Experiment?// posted by Mike 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 ...
ADSI Blog: Nine C’s of Successful Accountable Primary Care Delivery// posted by Tom Doerr
The Accountable Primary Care Model: New Hope for Medicare and Primary Care
ADSI Blog: Has Health Care Industry Transformation Reached its Tipping Point?// posted by Lumeris
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.
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.