Beyond the 5 Stars: Leveraging a Sustainable Model to Drive Consistent CMS Quality Metrics Performance in Value-based Care

The recent investment activity around value-based care within the Medicare Advantage space has demonstrated what was once an experiment is now a requirement for organizations to shift from surviving to thriving, sending a clear message that value-based care is here to stay. But the underlying question that remains year-after-year: Is there a sustainable value-based care model?

Dr. Debbie Zimmerman, Corporate Chief Medical Officer at Lumeris, has spent over a decade of her career to improve both the quality of care and the patient experience without compromising cost management through continuous innovation of proven business processes and best practices. In short, Dr. Zimmerman and her colleagues at Lumeris created a sustainable model for value-based care, achieving an average CMS Star rating of more than 4.5 stars for 13 straight years. It was this Lumeris model that subsequently earned their wholly owned and operated Essence Healthcare CMS’ highest ratings of 5 out of 5 stars for both 2022 and 2023. In a year when the average rating across all plans declined, consistent improvements over 2022’s 5 Star rating resulted in Essence Healthcare’s MAPD receiving a raw score of 5.115 from CMS.

Today, Lumeris works to help health systems and providers across the country accelerate their move to value-based care. Join Dr. Zimmerman and gain practical insights to achieve quality outcomes, exceptional patient experience and superior financial results as she shares how the Lumeris model drives performance behind the CMS quality metrics.

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