Category: Thought Leadership

Capitalizing on Comprehensive Care: Cultivating a Medicare Advantage Mindset

November 15, 2017 | By

Author: Richard Jones, Chief Executive Officer of Essence Healthcare & Chief Corporate Development Officer, Lumeris In response to the growing popularity of Medicare Advantage (MA) among consumers, the number of provider-sponsored MA plans is on the rise. Launching an MA plan offers health systems the potential to strengthen their bottom lines while acquiring the capabilities (…)

Your Star Ratings Just Came Out…Now What?

October 26, 2017 | By

By Martha Butler, Senior Vice President, Health Plan Operations Autumn is in full swing—the leaves are changing colors, pumpkin spice lattes are everywhere…and CMS just released the 2018 Star Ratings for Medicare Advantage (MA) plans. How did your organization fare? If you’re like the 56% of MAPD plans rated below 4 Stars, you may be (…)

Need to drive MA plan membership? Don’t ignore your Marketing and Sales strategy

September 13, 2017 | By

By Ben Kline, Business Development and Joel Andersen, Vice President, Marketing After considerable due diligence, your organization has decided to launch a Medicare Advantage (MA) plan. You evaluated the market and current MA enrollment. You examined market competitors, such as provider-sponsored organizations, regional insurance firms, and large national organizations. You gauged potential competitor responses, trying to figure (…)

Thinking about joining a provider collaborative? Not so fast…

September 8, 2017 | By

By Mitu Ramgopal, Business Development As health systems define their future state vision and how they will achieve the transition to value-based care, one approach that has emerged is to join a provider collaborative. Health systems are coming together to start sharing best practices and work toward common goals. However, it is critical to determine how (…)

Advantage Medicare Advantage: Delivering Healthcare’s Triple Aim to Seniors

August 4, 2017 | By

Each day, 10,000 Americans turn 65, and that trend will accelerate in 2019 and beyond. As the Baby Boomers reach Medicare eligibility, more and more are choosing Medicare Advantage to help them manage their health. Fueling seniors’ increasing preference for Medicare Advantage: predictable costs, additional benefits and care coordination. Forward-thinking health systems and insurers also (…)

White Paper: 40 Years in the Payment Reform Wilderness: DRGs to Nirvana

June 14, 2017 | By

In a perfect world, a well-functioning healthcare delivery system should provide the right care at the right time in the right place, while being accountable for clinical and financial outcomes. But the current method of paying for healthcare is broken. Since the inception of Medicare more than 50 years ago, the system has been designed (…)

White Paper: Reinvent & Reimagine Population Health: Interconnected Care Delivery

June 14, 2017 | By

In this paper, Reinvent & Reimagine Population Health: Interconnected Care Delivery, Lumeris author Kamesh Somanchi discusses the steps required for developing an interconnected platform to support value-based care delivery. While various population health management technology solutions have enabled healthcare organizations to start their transition to value, full transformation requires a comprehensive strategic and operational platform-based (…)

White Paper: Moving to Value with a Population Health Services Organization

June 14, 2017 | By

In their paper entitled, Moving to Value with a Population Health Services Organization, Lumeris authors Jeff Smith and Jay Shah provide an overview of the current healthcare market landscape and explore the economic, political, and social drivers influencing the move toward value-based care. This transformation, which requires a change in both the care delivery and (…)

Point of View: Five Components of a Successful Provider-Driven Population Health Services Organization

March 20, 2017 | By

A New Business Model for Provider Organizations Authors: Greg Scrine, Senior Vice President, Lumeris Advisory Services Ricky Garcia, Vice President, Lumeris Advisory Services   Ever-growing healthcare costs and the recognition that one-third or more of US healthcare spending is unnecessary, wasteful, or inappropriate have resulted in pressure on healthcare organizations to cut costs without harming (…)

What made Essence Healthcare’s 5-Star Rating for 2016 so remarkable?

March 3, 2017 | By

Richard Jones Discusses Essence Healthcare’s 5 Star Rating

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