New Lumeris Application Helps Medicare Advantage Plans Dramatically Improve Medicare Star Ratings

Company’s latest innovation addresses critical market need

ST. LOUIS--(BUSINESS WIRE)-- Lumeris, an affiliate of 4.5 star Medicare Advantage operator Essence Healthcare, today introduced a new application to help Medicare Advantage plans improve their Medicare star ratings. The application is the latest addition to the company’s popular Maestro technology platform, used by health plans and health systems to improve the quality and lower the cost of health care.

Lumeris’ star ratings application addresses new regulations affecting Medicare Advantage plan sponsors. Starting next year, Medicare Advantage reimbursement will be tied to health care quality and member satisfaction. Plans with the most Medicare stars will earn substantial bonuses and other incentives to help offset cuts to benchmark reimbursement levels.

“The newfound importance of Medicare star ratings is difficult to overstate,” said Richard Jones, a managed care veteran and president of Lumeris. “Earning the highest-possible star rating requires that Medicare Advantage plans become better at finding and acting on the most meaningful opportunities for clinical improvement. This application is a valuable new tool for those plans that are serious about making significant and rapid changes to their star ratings.”

Jones added that some of the nation’s highest-rated Medicare Advantage plans already use Lumeris’ Internet-based technology to further increase quality, lower costs and maximize revenue through improved documentation and HCC coding.

Among other things, Lumeris’ new Medicare star rating application lets users:

  • Compare individual physician and group performance against others in the plan network. Using the application, network doctors can view and easily compare the quality of their care against other doctors in a given group or geography. This benchmarking feature has shown itself a powerful tool in changing physician behavior.
  • Examine specific clinical measures to understand which patients are contributing to the overall star rating. With a few clicks, doctors or health plan executives can immediately view the specific members who require additional outreach or clinical attention in order to improve a star rating measure.
  • Take specific steps to improve performance on a given star measure. The new application articulates the specific actions necessary to improve quality for a specific member, and makes it easier for a network provider’s office staff to take those actions.

“Lumeris’ Medicare Advantage star rating application lets health care providers not only view population-specific information but also access very detailed and actionable information about individual plan members,” said Debbie Zimmerman, MD, Chief Medical Officer at Lumeris. “This is important because it allows physicians in a plan’s network to address multiple overdue measures during a single office visit. With this application, a physician can quickly find their patient in the Maestro system and immediately view all of the opportunities for quality improvement applicable to that individual.”

“The pace of Lumeris’ product development efforts continues to increase, and we look forward to announcing additional new product functionality in the coming months, based on feedback from our growing base of health plan and health system users,” said Jones.

About Lumeris

Lumeris develops the tools and technology used by health plans, health systems and Accountable Care Organizations (ACOs) to improve the quality and lower the cost of health care. Backed by the Silicon Valley investor who jumpstarted Google, and advised by some of health care’s most innovative thought leaders, Lumeris is remaking the U.S. health care system through information technologies that support more accountable and patient-centered care. To learn more about Lumeris, call 1.888.LUMERIS (1.888.586.3747) or visit

Lumeris and Maestro are trademarks of Lumeris, Inc., a wholly owned subsidiary of EGHC.


Andrew Shea, 314-209-2865
[email protected]
Lois Paul & Partners
Maribel Lopez, 781-782-5719
[email protected]

KEYWORDS:   United States  North America  Missouri

INDUSTRY KEYWORDS:   Technology  Data Management  Software  Practice Management  Health  Managed Care




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