Lumeris Recognizes Essence Healthcare for Earning CMS Rating of 4.5 Stars or Better for 7 Consecutive Years

Managed Care Weekly Digest

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Lumeris, the industry leader in value-based care solutions, announced that the Centers of Medicare and Medicaid Services (CMS) has awarded long-time Lumeris client Essence Healthcare 4.5 out of 5 stars in its annual quality assessment of Medicare Advantage plans. The St. Louis-based Essence Healthcare has earned a 4.5 star rating or better for seven consecutive years (see also Lumeris).

"We're honored that CMS has once again recognized Essence Healthcare for our high-quality performance and for achieving a high level of consumer satisfaction with our services," said Richard Jones, CEO of Essence Healthcare. "Our collaboration with Lumeris has been instrumental to our success and allowed us to remain focused on protecting the health and wellness of our Medicare beneficiaries. The Lumeris value-based model continues to incent and enable providers to optimize their clinical and financial success through the efficient delivery of patient care."

Essence Healthcare, which serves over 60,000 beneficiaries across Missouri and Illinois, offers a unique collaborative approach to Medicare Advantage insurance by working with providers in a virtual integrated delivery system. Lumeris supports Essence Healthcare's efforts with transformative technology and engagement services that give providers the actionable clinical and financial data they need to proactively manage and coordinate patient care.

"Essence is among an elite number of Medicare Advantage plans that achieved a 4.5 star rating or higher for 2018, and the only HMO plan in Missouri to earn that distinction," said Jones. "By maintaining a high star rating for seven straight years, we have demonstrated the power and success of a collaborative payer and provider approach that leverages innovative technologies and effectively engages physicians and consumers to drive adherence to clinical and quality measures."

The Star Ratings system allows Medicare beneficiaries, their families and caregivers to compare the quality of available health and drug plans. Plans are rated on a 1 to 5 star scale, with 1 star representing poor performance and 5 stars representing excellent performance. Less than 19 percent of Medicare Advantage Part D plans earned 4.5 stars or higher for 2018.