About: Lumeris helped rescue a struggling Medicare Advantage plan by implementing its Collaborative Payer™ Model™, which rewards providers for high-quality, efficient care. Initially challenged by weak physician engagement, poor clinical outcomes and a medical-cost ratio exceeding 100%, the plan was able to increase visits by primary care physicians, improve health-screening rates and reduce hospital admissions and lengths of stay. This was accomplished by identifying a new provider group partner and negotiating a collaborative shared-savings contract with strong incentives. Providers became population health managers through information transparency, regular communication and continuous training and improvement.
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