July 16, 2018
Mutual of Omaha and Lumeris, the industry leader in value-based care, today announced they will launch new Medicare Advantage (MA) plans to deliver health care and promote wellness to seniors across greater Cincinnati with the help of two local health care systems, TriHealth and St. Elizabeth Healthcare. The new plans will be available for the 2019 plan year.
“In 2014, TriHealth and St. Elizabeth’s forged an innovative partnership through the creation of Health Solutions Network to get health care right for the Greater Cincinnati and Northern Kentucky communities by working together to provide better care, better health and better value,” said Randall Curnow, MD, MBA, medical director for population health at TriHealth. “And now this collaboration with a trusted company like Mutual of Omaha will enable us to expand our reach in offering innovative Medicare Advantage health care solutions to the senior community, a population that has been particularly affected by the rapid changes in the health care industry.”
TriHealth and St. Elizabeth Healthcare selected Mutual and Lumeris based on Mutual’s leadership in the senior market and Lumeris’ extensive experience helping providers to develop, operationalize and execute on value-based strategies for Medicare Advantage plans.
“When evaluating an MA plan, we quickly realized that Mutual of Omaha and Lumeris have deep industry expertise, and also have clinical and financial priorities closely aligned with ours – and that alignment is critical to success in any value-based effort,” said Lori Ritchey-Baldwin, chief financial officer of St. Elizabeth Healthcare.
Under the terms of the agreement, Mutual and Lumeris will market the plan, manage day-to-day operations and support the optimization of the health systems’ high-quality clinically integrated network, Healthcare Solutions Network. This proven value-based care model for Medicare Advantage emphasizes collaborative relationships between patients, providers and payers.
“The strategic alliance between Mutual of Omaha and Lumeris is based on both organizations’ commitment to its customers and to delivering top quality care for seniors. TriHealth and St. Elizabeth are two systems that share this vision and are dedicated to making a difference in patients’ lives,” said Amber Rinehart, senior vice president of senior health solutions at Mutual. “As Mutual and Lumeris were considering the best markets to launch our initial MA plans, Cincinnati soon became one of our top choices because of the opportunity to serve a growing number of Medicare-age patients and partner with likeminded health care organizations in the region.”
According to Jeff Carroll, executive vice president of health plans at Lumeris, “TriHealth and St. Elizabeth are two outstanding provider organizations that have demonstrated a commitment to the delivery of value-based care aligned with Lumeris’ Triple Aim Plus One: better health outcomes, lower costs, and improved patient outcomes, plus physician satisfaction. We are excited to work with both systems to advance health and wellness in the Cincinnati region – and we are confident that our collaboration will successfully transform the delivery of care for seniors.”
TriHealth and St. Elizabeth Healthcare are founding members of the clinically integrated Healthcare Solutions Network, which began operations in 2015. TriHealth is a unified health system based in Cincinnati that was formed in 1995 to bring together physicians, Bethesda and Good Samaritan Hospitals and the community. Today the system is comprised of five hospitals: Bethesda North, Good Samaritan, Bethesda Butler, McCullough-Hyde Memorial Hospital and TriHealth Evendale. St. Elizabeth Healthcare operates six facilities throughout Northern Kentucky and more than 115 primary care and specialty office locations in Kentucky, Indiana and Ohio. St. Elizabeth serves more than 315,000 patients annually, 10,000 of whom seek treatment for cancer.