Lumeris, a provider of the technology, insurance capabilities and expertise to support value-based care models, said that its Medicare Advantage plan Essence Healthcare will expand into five new states and 44 new counties next year.
Beginning Jan. 1, 2023, Essence, which previously operated in California, Illinois, and Missouri, will enter the Indiana, Kentucky, Arkansas, Georgia, and Ohio state Medicare Advantage marketplaces.
St. Louis-based Lumeris said this is a 223 percent increase in county coverage in one year, and attributed the growth customer and provider satisfaction with Essence’s plan and benefits.
“We are passionate about our vision to create the system of care every doctor wants for their own family,” said Michael Long, chairman and CEO of Lumeris, in a statement. “While the healthcare delivery system in the United States has struggled to balance quality, cost, and patient and physician satisfaction, Lumeris has demonstrated that it is not only possible, but also scalable. We are pleased to expand our provider partnerships to bring Essence Healthcare to a growing number of seniors.”
Lumeris said its expansion includes new partnerships with seven health systems. “Northeast Georgia Health System and Health Partners/HP2 are excited to launch a new Medicare Advantage plan in Georgia on January 1, 2023, Essence Health,” said Steve McNeilly, Northeast Georgia Health System COO Population Health & Vice President, Managed Care, in a statement. “The partnership with Essence Health will build upon the framework of our clinically integrated network HP2, with a focus on exceptional patient experience, coordinated value-based care delivery and improved quality, outcomes, and cost. This new partnership with Essence Health supports our mission, to improve the health of the community in all we do.”
The company noted that Essence’s St. Louis plan is among a short list of plans nationwide awarded Medicare’s highest overall plan rating of 5 out of 5 stars two years in a row for 2022 and 2023.The plan was also awarded “Best Medicare Advantage plan” in Illinois and Missouri for 2022 and 2023 by U.S. News & World Report.
Lumeris also serves as an operating partner for health systems in Direct Contracting /ACO REACH by providing end-to-end services and technology to help them be successful in managing this downside risk program.
