LUMERIS PURPoSE-bUILt SoLUtIon FoR PoPULatIon HEaLtH ManagEMEnt

1.888.586.3747 • Lumeris.com

The ability of a health delivery organization to become a Population Health Services Organization (PHSO) is dependent on integrating large amounts of disparate data, and then making it accessible to the entire Accountable Care Team (ACT), and using it to inform patients and impact outcomes.

© 2014 Lumeris

The AccounTAbLe DeLivery sysTem PLATform

The backbone technology is Lumeris’ Accountable Delivery System Platform (ADSP)® which was specifically built for population health management. It has a proven track record in the Lumeris-operated Medicare Advantage plan, as well as with health systems, payers and providers across the country. The ADSP is an integrated control system to critical and financial information for accountable care, enabling access by providers, key accountable delivery system executives and ACTs. As a result, the care team can make timely, value-based healthcare decisions that accomplish the Triple Aim Plus One: better health outcomes, lower costs and improved patient plus physician satisfaction.

To provide meaningful insight, technology needs to work horizontally across the value chain and provide the specific information for each participant. For example, payers and providers each have unique needs.

•Forpayers,theplatformshouldmonitorcostandutilizationofthecontractedproviders. •Forproviders,theplatformshoulddisplaymanagedpopulationsanda360-degreeviewofpatientswithworklists that streamline daily practice.

For over a decade, Lumeris has developed and deployed technology specifically designed to manage population health. And, Lumeris solutions have been tested on MA plans that have been rated at 4.5 Stars for the past four years.

The Lumeris cLouD

The proprietary engine that integrates the data is an advanced solution that enables information exchange between the healthcare enterprise, third-party systems and data sources. Data from various sources, in different formats, is parsed, converted and stored in the platform’s data warehouse. Then, the data is made accessible through a cloud-based infrastructure, allowing access for clients and users across devices and locations.

The cloud is tightly secured, and all data is safeguarded and protected. Clients can be confident in Lumeris’ backup and recovery processes that ensure continued business performance for all approved users.

To learn more, call 1.888.586.3747 or visit Lumeris.com

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The ADsP:

•Aggregatesandanalyzesdataacrossthecontinuum of care — including EMR

encounter data, adjudicated claims, pharmacy, lab, and other data — and

stores it in the Lumeris data warehouse

•Establishesaunified,accurateview of patient care and population health

•Minesdataforclinicalandfinancial improvement opportunities

•Sendsactionableclinicalandfinancialintelligence to providers and other decision-makers, providing complete visibility into the patterns and behaviors that drive costs and impact outcomes.

Effective PHSOs require physician-led care teams that have interactive and real-timetoolsthatprovidea360-degreeview of patients. As patients accept more responsibility for their own care, it is vital they are engaged and have access to the same tools and information.

Consumer engagement is central to the care management team, and the ADSP technology allows them to:•Tracktheirownhealthandwellness

in a common platform that is integrated with the latest personal health monitoring devices and smart-phone applications•Accessclinicalandpatienteducation materials for more information and better decision-making•Workdirectlywiththeircareteams with reminders, appointments, secure messaging, referral management and recording of their progress toward goals.

The solution allows physician-led accountable teams to:•Viewandtrackthesamereports, tools, dashboards and analytics that are available in the ADSP•Monitorpatientsandintervenewhen necessary•Expandtheircapacitysincethe rules engine automatically populates population health management•Followworkflowsandproduce efficient, coordinated care.

Nurse

Employer

Home Health Nurse

PCP

Care Coordinator

SpecialistCMO

Health SystemCEO

Health PlanCEO

CFO

Hospitalist

Pharmacist

Patient

Caregiver

CARE MANAGEMENT

QUALITY MANAGEMENT

COST ANDUTILIZATION

MANAGEMENT

REVENUEMANAGEMENT

PROVIDER ENGAGEMENT

INTE GR ATIONS E R V I C E B U S

UNIFIEDMEDICAL R

ECO

RDP

ERFO

RMANCE

MG

T EN

GINE

DATA WAREHOUSE

APPLICATION SERVICESDATA & IMPLEMENTATION SERVICESORGANIZATIONAL TRANSFORMATION SERVICES

EMR EncounterData

ClaimsData

Pharmacy/Lab Data

Medical Evidence,Metrics, Benchmarks

Role-Based Systems

PhysiciAn-LeD, consumer-cenTric soLuTions

TheADSP’stools,reports,analyticsandworkflowssupporthealthsystems,payersandprovidersastheybecomePHSOs,and it helps them manage quality, cost and utilization metrics as part of any value-based contract.

Measure Summary TablePatient Worklist Patient Care Profile