– Mary Washington forms a strategic partnership with Lumeris to launch a new Medicare Advantage plan in 2020
– Lumeris will manage the Medicare Advantage plan operations including enrollment, claims processing, and provide infrastructure and governance.
– Lumeris will also help Mary Washington with the development and deployment of a value-based care strategy to drive programs to educate, incent, and engage providers.
Mary Washington Healthcare, a not-for-profit health system that primarily serves 7 counties in Fredericksburg, Virginia announced it will launch a new Medicare Advantage plan in January 2020. In addition, the announcement Mary Washington has formed a strategic partnership with Lumeris, a value-based care managed services operator for health systems and providers to drive the development, deployment, and operation of the Medicare Advantage plan.
Expansion of Mary Washington’s Value-Based Service Offerings
The announcements follow five years of success participating in Medicare’s Shared Savings and Next Gen Programs, Mary Washington Healthcare has opted to expand its value-based service offerings to include a Medicare Advantage plan for the region’s senior population. Mary Washington Healthcare is currently the region’s largest health system with two hospitals and over 500 physicians across its clinically-integrated network.
As part of the strategic partnership, Lumeris will handle all of the health plan’s day-to-day operations, including enrollment and claims processing, and provide infrastructure and governance. Lumeris will also assist Mary Washington Healthcare with the development and deployment of a value-based care strategy and develop and drive programs to educate, incent and engage providers.
Lumeris’ Data-Driven Delivery Model
Lumeris has more than 10 years of experience working with providers to deliver industry-leading clinical and financial outcomes. The company has developed a proven transformative care delivery model that emphasizes patient wellness and the pursuit of the Triple Aim Plus One, defined as better health outcomes, lower costs, enhanced patient experience, plus markedly improved physician satisfaction. Lumeris’ data-driven care delivery model consistently improves value-based outcomes across populations.
For the past eight years, Lumeris with Essence Healthcare, its inaugural client with more than 63,000 Medicare members in Missouri and Illinois, has received 4.5- to 5-Star Ratings from the CMS and produced the highest consumer and physician satisfaction scores in the industry along with significantly better clinical outcomes and lower costs.
The Bigger PIcture
More than 11,000 baby boomers turn 65 each day and enter the Medicare market. CMS has projected that Medicare Advantage enrollment will reach an “all-time high” in 2019 with 22.6 million Medicare beneficiaries, given the unprecedented growth. Medicare Advantage plans are one of the frontline players in the push for value-based care and need to gear up to achieve an excellent care ecosystem for their members with the best clinical and financial outcomes.
After remaining flat for four years, the total number of Medicare Advantage plans increased 34 percent in the last two years to 2,734. The increased number of plans has expanded options for enrollees and created competition amongst insurers. The average recipient is able to choose between 24 plans in 2019, compared to 19 two years earlier.
Why It Matters
“In launching Mary Washington Medicare Advantage, our goal is to deliver better-coordinated care for our patients,” said Michael McDermott, president, and CEO of Mary Washington Healthcare. “We are excited to work with our collaborative partner Lumeris to help transform how we deliver care and help us drive better health across our patient population. After evaluating alternatives, Lumeris quickly stood out as the company with the most experience and success helping providers successfully stand up their own Medicare Advantage plans.”