Putting
Value-Based Care Into Practice
ilumed improves the quality and efficiency of care through infrastructure built to last and a partnership built on trust. We partner with primary care practices to help them successfully participate in CMS value-based care programs.
What value-based care means
For your practice and your patients
- *Comprehensive Provider Support: Reduce burdens with resources that let you focus on patient care.
- *Shared Surplus Opportunity: Providers earn quality-based payments tied to better outcomes.
- *Data-Driven Insights: Use analytics to optimize care delivery and identify at-risk patients.
- *Operational Flexibility: Participate at your own pace without disrupting existing workflows.
- *Enhanced Patient Care: Deliver comprehensive, patient-centered care with targeted support.
- *Improved Health Equity: Address disparities to provide better care for underserved populations.
How ilumed makes a difference
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Reduced Emergency Visits
ilumed’s clinical teams work with primary care physicians to review medication regimens for patients with conditions such as Congestive Heart Failure. This targeted approach reduces unnecessary ER visits and preventable hospitalizations, keeping patients at home and healthy.
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Chronic Disease Management
ilumed equips providers with better tools for addressing the root cause of chronic illness, including financial strain, food insecurity, and transportation barriers. Our care teams work directly with patients to support treatment adherence and close care gaps before they become crises.
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Reduction in Readmissions
For patients leaving the hospital, ilumed coordinates follow-up visits within seven days. This structured transition support has reduced the likelihood of readmission by approximately 50%.
How ACO REACH compares to other
Medicare models
Discover how the ACO REACH model stacks up against traditional Medicare as well as Medicare Advantage for beneficiaries.
| Model feature | Traditional Medicare | MSSP | ACO REACH |
|---|---|---|---|
| Maximum provider choice | |||
| No referrals/ pre-authorizations |
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| Prospective Capitation Payments to Primary Care Physicians | |||
| Engage a Portion of Group Practice in VBC | |||
| Simplified Quality Metrics |
See whether ilumed is the right partner for your practice
Our team works with practices at every stage, from initial exploration to active program participation. Let’s start a conversation to uncover the possibilities.
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Reduced emergency visits
Unnecessary ER visits cost the system $32 billion a year.¹
Reduced emergency visits
Using insights from Medicare claims data, patients with chronic diseases, like Congestive Heart Failure, are reviewed to ensure they are on the right compliment of medications. ilumed Medical Directors work with primary care physicians, and supporting clinical pharmacists to optimize guideline directed medical therapy. These medication adjustments reduce emergency department visits and unnecessary hospitalizations.
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Chronic disease management
Chronic conditions account for 90% of national health costs.²
Chronic disease management
ilumed gives providers better tools for treating underlying causes that can exacerbate chronic illness like financial strain, food insecurity and transportation barriers. ACO REACH teams help patients adhere to their treatment plans with personalized support.
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Reduction in readmissions
Approximately 20% of all Medicare beneficiaries experience hospital readmission within 30 days.³
Reduction in readmissions
ilumed partners with a patient's primary care physician to ensure a follow-up visit post hospital discharge takes place within seven days. These critical visits reduce the likelihood of a hospital readmission by approximately 50%.
FAQs about ilumed’s value-based care
Provider FAQs
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Value-based care is a healthcare model focused on improving patient outcomes while reducing unnecessary costs. Unlike traditional fee-for-service care, which reimburses providers based on volume, value-based care rewards providers for quality, coordination, and overall patient health.
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Primary care providers serve as the first point of contact and ongoing coordinator for a patient’s health. In value-based care, they play a critical role in managing chronic conditions, coordinating specialists, and preventing avoidable hospitalizations. This leads to better outcomes and lower costs.
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Success in value-based care looks different for every practice. ilumed works with practices at all stages, providing the level of support that aligns with their needs and current capabilities. This can include access to actionable data, care coordination support, workflow and documentation optimization, patient engagement strategies, and alignment with value-based incentives.
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Traditional Medicare patients retain 100% of their benefits, including access to acre from any provider who accepts Medicare.
Patients are aligned to an ACO REACH entity’s contracted primary care practioner (e.g., MD, DO, NP, PA) by the Centers for Medicare & Medicaid Services (CMS) through a review of historical primary care claims. Patients can also voluntarily align themselves to the contracted primary care provider.
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- ACO REACH (Accountable Care Organization Realizing Equity, Access, and Community Health)
- Medicare Shared Savings Program (MSSP)
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The onboarding process is designed to be collaborative and tailored to each practice. It typically includes:
- An initial assessment of current workflows and performance
- Alignment with goals and program participation
- Implementation of tools, reporting, and care team support
- Ongoing training and optimization
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ilumed enhances the patient experience by extending the care team beyond the physician’s office. Support may include:
- RN Care Coach outreach for chronic condition management
- Post-discharge follow-up to reduce readmissions
- Social Work support for social determinants of health
- Assistance connecting patients to community and financial resources