February 22, 2024

TriHealth Improves Quality of Patient Care and Value for Medicare Beneficiaries in the Region


Cincinnati, OH Feb. 22, 2024 – TriHealth, Cincinnati’s nationally-recognized health care system, is pleased to announce the results generated by its Population Health Organization (PHO) to improve the quality and value of care received by local Medicare beneficiaries in one of the Centers for Medicare & Medicaid Services’ (CMS) most advanced innovation programs.

TriHealth’s PHO generated savings of $17 million to CMS for calendar year 2022 while simultaneously keeping patients healthier and more satisfied with their care. This work included more than 1,400 participating health care providers in the region and affected the care for nearly 22,000 traditional Medicare patients.

“We accomplished these savings by improving access and timeliness to needed care and proactively managing chronic conditions before they could result in more serious events,” said TriHealth PHO President Dr. Raymond Metzger. “By providing the right care at the right time using data analytics and evidence-based standards, we ensure TriHealth patients are receiving the best care. This includes outreach programs and interventions to make sure patients are receiving preventative screenings such as colonoscopies and mammograms and removing barriers to care including obstacles that would otherwise prevent patients from receiving routine, preventative and necessary medical care.”

TriHealth PHO’s approach for treating Medicare patients is one of the reasons it has been recognized by Health Plans as a top Accountable Care Organization (ACO) health care provider in the country for managing chronic conditions, having significantly higher rates of patient experience and compliance for routine, preventative screenings while reducing the overall cost of patient care.

TriHealth partners with Lumeris value-based care enablement company that empowers health systems and providers to deliver outstanding outcomes. TriHealth and Lumeris are continuing to partner to advance proven models of care delivery that positively impact health outcomes across all patient populations, creating additional value for the community along with governmental and employer purchasers.

More about TriHealth
TriHealth is hospitals, physicians and the community working together to help people live better. We provide clinical, educational, preventive, and social programs through Bethesda North, Bethesda Butler, Good Samaritan and McCullough-Hyde hospitals, and more than 140 other locations throughout Greater Cincinnati. This includes an ambulatory network, physician practices, research division, employer-based health services, hospice care, and fitness and health facilities. Learn more at trihealth.com, Facebook.com/TriHealth, @TriHealth on Twitter, and at YouTube.com/TriHealth.

About Lumeris:

Lumeris is the market-leading value-based care enablement company with over 10 years of experience in helping health systems and physician practices succeed in value-based care. As a joint-operating partner in both value and risk, Lumeris delivers cutting-edge technology and extensive expertise to its partners. Lumeris partners consistently achieve superior quality metrics, patient experiences, physician satisfaction, and improvements in the total cost of care across Medicare Advantage, Original Medicare, Medicaid, and Commercial populations.

With more than $12 billion of medical spend under management across 12 markets, Lumeris is committed to creating a system of care that every doctor would want for their family. Lumeris’ Medicare Advantage Plan, Essence Healthcare, has received a 5-star rating from CMS for the past three years, further underlining Lumeris' commitment to excellence.

To learn more about Lumeris and its value-based care enablement solutions, please visit www.lumeris.com.

The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this release.