When decisions are clear, everyone shares in the rewards.

Lumeris is bringing common sense back to the business of healthcare by empowering value-based care. We create the partnerships and perspectives that are making healthcare safer, more affordable and more personalized for providers, patients and payers alike.

We were founded on the belief that it should be easier to provide the right care, at the right time, at the right cost. Our model is bringing that belief to life, improving outcomes and empowering financial sustainability along the way.

Lumeris & CAPG Panel: Providing Meaningful Incentives for Physicians as the Model Changes

Lumeris’ John Doerr and Debbie Zimmerman speak with CAPG executives on behavioral economics, payer-provider partnerships and the role of enabling technology.
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The Lumeris difference.

Our model is proven.

Lumeris’ model for value-based care delivery has achieved recognition for its ability to improve outcomes across populations, with results validated by AON Hewitt. For more than 10 years, we have operated one of the highest performing Medicare Advantage plans in the country as measured by clinical and financial outcomes, as well as member and physician satisfaction.

We know data inside and out.

We help our partners add value to their existing infrastructure by transforming clinical and organizational data into groundbreaking insights. Our solutions help advance population health, improve provider and patient experiences and enhance financial stability.

We know the way.

Whether we’re advising, redesigning infrastructure, or helping to manage a new care model, we ensure the steps are always clear and pragmatic. Our clients have access to a deeply experienced management team that is passionate about client success and achieving market-leading results.

We work side-by-side with you.

We adapt quickly to the needs and nuances of every healthcare organization we collaborate with, sharing knowledge and dynamic technology to deliver better outcomes together.

We see the future of healthcare.

We relentlessly pursue new ways to solve known and unknown healthcare challenges. Since our founding, we’ve pushed the industry forward not for the sake of innovation, but because it’s the right thing to do.

Our history.

A decade ago, a team of healthcare executives asked themselves a question: What are the most pressing issues in healthcare, and how do we fix them? For the system to thrive, the adversarial relationship between payers and providers had to end. This called for an innovative approach, with economics and data shared freely across the continuum of care. It meant incentives for behavior – not punishments – supported with the right information and tools.

These executives set out to fulfill their mission by establishing the first collaborative payer, Essence Healthcare. Under their model, Essence did not own the continuum of care, but worked collaboratively with providers in a virtual integrated delivery system. Essence Healthcare established new value-based reimbursement models to align incentives, affording providers the time to more proactively manage and coordinate patient care. It also developed cloud-based technology to deliver actionable clinical and financial data to providers, along with the tools to leverage that information.

The results were nothing short of remarkable. Costs dropped. Quality improved. Patient satisfaction increased. And, provider engagement grew. Essence Healthcare had united the continuum of care in a common purpose. Today, with the nation’s healthcare industry still struggling and the concept of value-based accountability on the rise, Lumeris continues to share these transformative technologies, programs and methods with health plans, hospitals and other organizations.

Partner organizations.

The Accountable Delivery System Institute, the premier educational resource for accountable care, provides proven solutions and practical advice to healthcare organizations seeking the benefits of a more connected and aligned healthcare model.

Essence Healthcare is a Lumeris-operated Medicare Advantage plan with a CMS rating of 4.5 to 5 stars for the past six years. Essence Healthcare offers Medicare beneficiaries comprehensive, affordable insurance that focuses on wellness, care coordination and personal service.