Lumeris

Lumeris operates as a value-based care managed services operator, providing health systems and physician groups with the necessary technology, services, and advanced risk management capabilities to transition from fee-for-service to value-based care models. The company's business model is centered on forming collaborative, risk-sharing partnerships with healthcare providers to improve clinical and financial outcomes. Revenue is generated through these partnerships, where Lumeris's success is financially aligned with its partners' ability to deliver cost-effective, high-quality care. The company serves a diverse client base that includes health systems, physician groups, and payers managing Medicare Advantage, traditional Medicare, Medicaid, and commercial populations.

The company's origins trace back to a physician group that formed Essence Healthcare, a fully insured Medicare Advantage plan, in 2004. Lumeris was officially launched in 2011 to bring the proven clinical and financial model of Essence Healthcare to the broader market. While some sources state a founding year of 2001 with key founders Dr. Tom Doerr and Nigel Ohrenstein, the company itself marks 2011 as its market entry. Lumeris operates as a subsidiary of Essence Group Holdings Corporation. The company is led by Chairman and CEO W. Michael Long, a seasoned entrepreneur with a notable background in building and leading companies like Healtheon/WebMD, Continuum, and Move/Realtor.com. His extensive experience in healthcare technology and transaction clearinghouses directly informs Lumeris's strategic direction.

Lumeris's core offering is its Population Health Services Organization (PHSO), a solution that combines technology, processes, and expertise to manage patient populations effectively. A key component is the AI-powered technology platform, Tom™, which integrates into clinical workflows to provide 'best next actions' like scheduling screenings and managing chronic diseases. This platform helps orchestrate care, reduce administrative burdens, and provide actionable data insights to providers. The company manages over $13 billion in medical spend and serves more than one million patients through its partnerships. A significant milestone was a $100 million equity capital raise in April 2024 to support expansion.

Keywords: value-based care, population health management, healthcare technology, managed services operator, physician enablement, Medicare Advantage, risk management, clinical outcomes, financial outcomes, Essence Healthcare, PHSO, healthcare analytics, care coordination, health systems partnerships, payer solutions, patient engagement, medical spend management, accountable care, healthcare consulting, AI in healthcare