Is Healing Medicare the Key to Health Equity?

“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 document.”


How can providers support patients between appointments?

We’re not telling you anything you don’t already know, but what happens to your patients outside the exam room is just as important as what happens inside it.

Each day, you see firsthand how loneliness and isolation can negatively impact your patients’ physical and mental health. You encounter patients who are forced to make a choice between paying for necessary prescriptions and buying groceries for the week or keeping the lights and heat on at their residence. You hear patients explain that they have no reliable transportation to get to and from doctor’s appointments or the pharmacy. 

Despite your common goal to ensure that all patients have access to quality care and treatment, it can be a challenge for healthcare providers to make big strides toward health equity when they are focused on the main task at hand: the individual health needs of their patients. That’s where ilumed comes in. By using data to identify the most at-risk patients, providing home support through our concierge services and working with patients and providers to provide financial support, we help healthcare providers bridge the gap between individual health and population health.

How can we determine who needs our help the most?

You know that certain patients are more at risk than others for social determinants of health, but how do you begin to pinpoint which patients need the most help? Leave that to us. ilumed’s industry-leading BrainStream platform identifies at-risk patients using data algorithms. This objective and equitable process ensures that care isn’t provided on a subjective basis, and improves the provider’s workflow and promotes a simpler way to provide value-based care.

BrainStream reports also help ilumed staff make more strategic choices for disease management and case-management support. Armed with the data they need to help patients from a clinical perspective, ilumed staff are able to take actionable, measurable steps to help improve health outcomes, rather than simply checking boxes. By using the insights from BrainStream reports, providers can create personalized care and management plans that don’t end as soon as a patient leaves the exam room.

Healthy living begins at home

As much as you would like to, it is impossible to follow each patient home and ensure that they have what they need to stick to their disease management plan and maintain a good quality of life. With ilumed’s concierge services, you’ve got the next best thing. We provide home support that is eligible to every beneficiary, regardless of income. Our concierge-services staff gets to know beneficiaries as individuals, creating personal relationships with them and learning their unique wants, needs and preferences. 

In addition to helping with appointment scheduling, arranging transportation and promoting medication adherence, ilumed’s concierge-services staff also helps connect beneficiaries to local community resources. While ilumed recognizes that food issues are not a one-size-fits-all problem and that needs can vary by individual circumstances of a person or location, we are committed to help increase the availability and accessibility of food to beneficiaries in our partner provider groups. 

For example, ilumed worked with the staff at Medical Specialists of the Palm Beaches, a provider group in Palm Beach, Florida, to initiate a weekly food delivery service for beneficiaries in need. In addition, our founder, Debra A. Finnel, was recognized by Feeding America for spearheading an innovative solution to use physicians’ offices as a pathway for food distribution in San Antonio, Texas. By helping providers reach their patients at home, ilumed makes great strides to bring health equity to members of underserved populations.

An Ounce of Prevention is Worth a Pound of Cure

Of course, one of the biggest social determinants of health that can impact patients and providers alike is money. An inability to afford primary care provider (PCP) copays may deter a patient from seeking care for an acute or chronic medical condition. ilumed works to eliminate this barrier by waiving PCP copays for at-risk patients. In addition, our concierge transportation services can remove another obstacle for patients without affordable or reliable transportation to and from doctor visits or the pharmacy, making it easier for them to manage chronic conditions and stick to their personalized care plans. More frequent preventive care plus clinical and concierge support between visits makes it easier for beneficiaries to maintain lifestyle adjustments and adhere to their medications. This, in turn, can help lower their medical costs in the long run by reducing hospital stays and ER visits and mitigating the costs of chronic conditions. 

While nothing beats the intrinsic reward of seeing their patients’ health benefit from these positive changes, providers also have much to gain by partnering with ilumed. As one of the most generous financial models among DCE (soon to be ACO REACH), ilumed helps solve common pain points among healthcare providers as they transition from fee-for-service (FFS) to value-based care (VBC). A number of providers in primary care don’t feel like they have the tools to keep people healthy; they just respond to what feels like an unreasonable patient load. With the VBC model, providers see fewer patients, but are able to do more for them. With our wide range of clinical and concierge services, along with operational and financial guidance, ilumed helps providers do what they do best and enjoy most: provide better care and achieve better outcomes for their patients. 

In addition, ilumed helps providers make the transition from the traditional FFS claims model to VBC’s alternative payment model. Stretching healthcare dollars to provide better care rewards providers financially for their hard work in improving patient outcomes. Even more important, the VBC model allows doctors to do what got them into medicine in the first place. Providers get the time they need and want to provide the most comprehensive care to their patients, and they get to know them on a deeper level as people, not just case numbers. Partnering with ilumed helps providers receive much-deserved emotional and financial reward for their hard work in improving patient outcomes. 

Paving the Way Forward

As healing Medicare takes center stage, ilumed’s caliber of innovation and vision is setting the standard for the rest of the industry. We have been recognized by the Centers for Medicare & Medicaid Services (CMS) as a leader in the field, with our patient-engagement letter making such an impression on CMS that it is now being used in cross-model learning activities and will be presented in future webinars focused on patient engagement. This unprecedented praise showcases how we are setting the pace for DCE (soon to be ACO REACH) models.

Together We Can Heal Healthcare

Using data to pinpoint at-risk beneficiaries, offering a variety of concierge services for all patients and providing support with financial matters for patients and providers alike are just some of the ways ilumed helps providers mitigate health disparities for members of underserved or vulnerable populations, improve population health and leverage health equity for beneficiaries of our partner provider groups.

To learn more about how ilumed is changing the face of healthcare, visit our FAQ page.


Questions about what we can do for your provider group? Connect with an ilumed team member here.