Lumeris Achieves 100% Quality Scores and Delivers $20.1M Savings to Medicare Trust Fund and Federal Government through ACO REACH

ST. LOUIS, Nov. 29, 2023 /PRNewswire/ — Lumeris, the market-leading value-based care enablement company, is proud to announce the outstanding performance of its participation in the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model through global risk. With a focus on quality care, Lumeris’ affiliate entities, serving 79,000 seniors under the care of 1,600 participant providers, achieved 100% quality scores while delivering a 4.3% gross savings rate, including $20.1M in savings to the Medicare Trust Fund and federal government for the 2022 performance year. News of the exceptional performance comes just a week after CMS announced that for the third year in a row, Essence Healthcare, Lumeris’ affiliate Medicare Advantage Plan, has received 5 Stars for the 2024 plan year.

Through ACO REACH participation, Lumeris deployed multiple solutions and engagement programs focused on improved access to care, complex care management, reduced avoidable readmissions and improved post-acute care coordination. “We are proud of the exceptional performance achieved by our provider partners in the ACO REACH model,” said Jean-Claude Saghbini, President of Lumeris Value-based Care Enablement. “These results showcase the power of our technology and approach in delivering superior high-quality care, improving patient experiences, and driving down avoidable costs.”

In addition to the 100% quality score, Lumeris engagement prioritized patient care, resulting in exceptional consumer ratings across various domains, including timely appointments, effective communication, care coordination, patient satisfaction, and more.

“Through this model of care, we can achieve better health, less illness and lower costs for our patients,” shares Dr. Charles Willey, Managing Partner of Vicinia Health.  “Our partnership and engagement with Lumeris in ACO REACH enables us to know which patients need us most, focusing attention where most impactful for health. We can prioritize and proactively outreach to patients based on need instead of waiting to see patients until they call. Through Lumeris we have physician cell phone alerts such as notice of ER visits which allows our physicians to co-manage care with ER and hospital physicians and have also implement a population focused hospitalist program and complex case outreach to homes and rehabs where we intervene early and prevent or ameliorate exacerbation. Our patients are healthier making the cost of their care lower. That’s healthcare the way it ought to be.”

“When you take on risk for a large Medicare population, some percentage of the patients will not have access to a qualified PCP and it is critical to make sure they receive the care coordination services that will allow them access to the healthcare system when and where they need it,” explains Saghbini. “Our technology and the many programs we have developed address important patient needs for managing chronic conditions, advanced illness, or even just routine medication adherence.

The exceptional performance in both Medicare Advantage and ACO REACH provides health systems and physician practices with a proven model to effectively manage Medicare risk and improve health outcomes for all senior populations. With this continued success, Lumeris remains at the forefront of driving innovation and transforming healthcare for seniors across the nation.

About Lumeris:

Lumeris is the market-leading value-based care enablement company with over 10 years of experience in helping health systems and physician practices succeed in value-based care. As a joint-operating partner in both value and risk, Lumeris delivers cutting-edge technology and extensive expertise to its partners. Lumeris partners consistently achieve superior quality metrics, patient experiences, physician satisfaction, and improvements in the total cost of care across Medicare Advantage, Original Medicare, Medicaid, and Commercial populations.

With more than $12 billion of medical spend under management across 12 markets, Lumeris is committed to creating a system of care that every doctor would want for their family. Lumeris’ affiliate Medicare Advantage Plan, Essence Healthcare, has received a 5-star rating from CMS for the past three years, further underlining Lumeris’ commitment to excellence.

To learn more about Lumeris and its value-based care enablement solutions, please visit www.lumeris.com.

The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document. 

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SOURCE Lumeris