• ARTICLE2_200X200

    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.

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    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.

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    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.

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    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 RELEASE2_200X200

    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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 ...

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    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.

  • ARTICLE2_200X200

    HealthITAnalytics Article: Healthcare analytics, big data, and BI vendor news

    // posted by Lumeris

    Aria Health and Lumeris announced a value-based initiative to improve the quality of care for nearly 20,000 Aria Health patients in Northeast Philadelphia by optimizing Aria Health’s performance on Independence Blue Cross’ (IBC) primary and accountable care payment models.

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    ACO News Article: Vendors, providers strike deals on HIT platforms

    // posted by Lumeris

    Aria Health and Lumeris announced a value-based initiative to improve the quality of care for nearly 20,000 Aria Health patients in Northeast Philadelphia by optimizing Aria Health’s performance on Independence Blue Cross’ (IBC) primary and accountable care payment models.

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    HealthITAnalytics Article: Aria Health and Lumeris team to optimize contract performance

    // posted by Lumeris

    Aria Health and Lumeris announced a value-based initiative to improve the quality of care for nearly 20,000 Aria Health patients in Northeast Philadelphia by optimizing Aria Health’s performance on Independence Blue Cross’ (IBC) primary and accountable care payment models.

  • NEWS RELEASE2_200X200

    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

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    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.

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    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.

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    ACO News Article: Physicians bite the bullet on risk, increase income

    // posted by Lumeris

    With all the changes to the healthcare system, many physicians feel they drew the short straw: more paperwork, more patients but less time to spend with them, and less money. A physician group in St. Louis founded Essence Healthcare, a Medicare Advantage plan, on the bet that they could make more money by practicing medicine more efficiently, but bearing the risks if those efficiencies weren’t achieved.

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    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.

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    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.

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    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.

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    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.

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    ACO News Article: Population Health Management Platforms: The Tool ACOs Need to Support the Triple Aim

    // posted by Lumeris

    Keith Blankenship, vice president of technical solutions for Lumeris, spoke with ACO News about how technological advances and government policies are creating opportunities for providers to share data and integrate disparate data feeds into actionable intelligence to engage patients in making more informed choices.

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    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.

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    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.

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    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).

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    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 RELEASE2_200X200

    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.

  • ARTICLE2_200X200

    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.

  • ARTICLE2_200X200

    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.

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    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.

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    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.

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    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.

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    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.

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    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.

  • ARTICLE2_200X200

    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 RELEASE2_200X200

    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 ...

  • WEBINAR2_200x200

    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.

  • ARTICLE2_200X200

    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."

  • ARTICLE2_200X200

    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.

  • ARTICLE2_200X200

    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.

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    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 RELEASE2_200X200

    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.

  • ARTICLE2_200X200

    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.

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    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.

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    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.

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    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.”

  • ARTICLE2_200X200

    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.”

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    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)®.

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    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.

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    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 ...

  • ARTICLE2_200X200

    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.

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    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.

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    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 RELEASE2_200X200

    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 ...

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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."

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    This Week in Accountable Care Article: This Week in Accountable Care with Tom Doerr, MD

    // posted by Lumeris
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    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.

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    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 RELEASE2_200X200

    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

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    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.

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    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.

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    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.

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    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.

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    Healthcare IT News Article: Nine C’s Part Two: The Back End

    // posted by Dr. Deborah Zimmerman

    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.

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    Healthcare IT News Article: Nine C’s Lead to Accountable Care

    // posted by Dr. Deborah Zimmerman

    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?”

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    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.

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    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."

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    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.

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    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

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    Healthcare Finance News Article: Real Time Data

    // posted by Lumeris

    Independence Blue Cross and regional provider Abington Health announced in late February they would leverage Lumeris' consulting and technology services to enhance their two-year-old accountable care initiative. Under the arrangement, IBC will feed claims data, pre-authorizations and lab results into Lumeris' cloud-based data and analytics platform, while Abington will feed information from its electronic health records in order to provide Abington care teams with close-to-real-time actionable data that can be used to manage patient care.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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."

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    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.

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    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.

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    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.

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    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.

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    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).

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    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.

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    Clinical Innovation Article: Health plans partner with Lumeris to purchase NaviNet

    // posted by Lumeris
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    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.

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    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.

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    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.

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    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.”

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.

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    Point of View: Quality Management

    // posted by Lumeris

    Quality Management: Empowering Payers, Health Systems and Providers to Achieve Optimal Health Outcomes.

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    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.

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    Point of View: The Value of Integrating EMR and Claims/Cost Data in the Transition to Population Health Management

    // posted by Lumeris

    Fill out the information below to download the point of view The Value of Integrating EMR and Claims/Cost Data in the Transition to Population Health Management. First Name* Last Name* Email Address* Company Accountable Care Challenges – Please Select –Population HealthConnectivity/TechnologyQuality/CostCost and UtilizationCare ManagementPhysician PortalConsulting needsProvider SatisfactionResults OrientedTotal ...

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    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.

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    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.

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    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.

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    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.

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    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.

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    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.