Cerner, Lumeris team up on population health
- Cerner continues to invest in population health management, striking a 10-year deal with Lumeris to develop an EHR-agnostic tool aimed at improving doctor-patient encounters and outcomes while controlling costs.
- Maestro Advantage seeks to streamline activities including claims processing and reimbursement cycles and reduce barriers to data sharing, the companies said Monday. The new product is intended for value-based models such as Medicare Advantage and provider-sponsored health plans.
- As part of the collaboration, Cerner will acquire $266 million shares in Lumeris’ parent company Essence Group Holding, according to a financial filing. EGH also owns Essence Healthcare, a 65,000-member Medicare Advantage plan in Missouri and Illinois, which Lumeris operates.
The strategic relationship underscores the popularity of population health and Medicare Advantage. The shift to value-based payment models has spurred interest in a range of products and services that help doctors and patients manage chronic conditions and social determinants of health. Meanwhile, Medicare Advantage membership grew to nearly 21 million enrollees last year, an 8% increase from 2016. It now accounts for 30% of all Medicare spend.
And CMS is showing support for population health efforts. A new Medicare Advantage rule gives plans more flexibility in determining the types of supplemental benefits they can offer chronically ill enrollees, including some that are nonmedical. The rule, issued in May, could see an array of new benefits aimed at addressing issues like housing, food insecurity, transportation and social isolation.
Leerink gave the deal a thumbs up for Cerner. “Lumeris is a top-ranked value-based care managed services vendor and received the Best in KLAS award in 2016, 2017 and 2018,” a research note said. “As well, the partnership helps broaden the company’s exposure to a growing area of the market. By 2018 the Department of Health and Human Services (HHS) wants to tie 90% of fee-for-service payments to quality and have 50% of all payments in category 3 and 4 alternative payment models,”
The companies contend that Maestro Advantage will increase access to primary care and deliver services on a par with pricey concierge medicine programs. Among its touted attributes are the ability to “integrate actionable data with provider workflows” and help providers maximize outcomes for patients in value-based health plans.
Lumeris will also embrace Cerner’s HealtheIntent population health platform.
“By using data to reduce or eliminate unnecessary costs and ineffective transitions of care, providing doctors and their patients a more complete view of their medical history and a health plan that consistently receives high quality scores from CMS, this collaboration with Lumeris aligns well with our mission and illustrates the potential of Cerner technology to positively impact health care economics and outcomes in deeper, more impactful ways than before,” Cerner CEO Brent Shafer said in a statement.
The relationship calls for Lumeris to adopt Cerner’s HealtheIntent platform and integrate its clinical methodology and data analytics with it. Initial deployments are slated to begin in the second half of this year, with full-scale rollout next year.