Blue Cross and Blue Shield of Kansas City Announces Medicare Advantage Plan

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Lumeris’ solutions will help insurer operate a new value-based offering to seniors

Blue Cross and Blue Shield of Kansas City (Blue KC), the largest not-for-profit health insurer in Missouri, is entering the Medicare Advantage market in 2015 with Blue Medicare Advantage plans available in nine counties in Kansas and Missouri (Cass, Clay, Clinton, Jackson, Lafayette, Platte, and Ray in Missouri, Johnson and Wyandotte in Kansas). Blue KC will offer two Medicare Advantage HMO plan options based on financial preferences and healthcare needs.

“Blue KC has been a trusted health insurance leader in Kansas City for more than 75 years and we are excited to offer Blue Medicare Advantage plans (designed by and for Kansas Citians),” said Danette Wilson, president and CEO of Blue KC. “We’ve put our years of local knowledge to work building affordable Medicare Advantage plans that will meet the needs of our community.”

To assist with its entrance into the Medicare Advantage space, Blue KC will partner with Lumeris, a pioneer in population health management solutions. With its near decade of experience in operating Essence Healthcare, a 4.5-Star rated Medicare Advantage Prescription Drug (MAPD) plan, Lumeris will help Blue KC establish a robust business model based on an integrated population health platform. Data collected will help physicians partner with patients in their care and the platform will interact with members to provide reminders, alerts, coaching advice and treatment information.

“We are pleased that Blue KC has partnered with Lumeris to design and manage an outcome-based health plan,” said Richard Jones, president and CEO of Essence Healthcare. “We are eager to take what we have learned from our 4.5-Star rated plan to position Blue KC for success.”

Blue KC has been leading the way for its members to experience improved healthcare delivery through a coordinated care model it launched in 2009. With Blue Medicare Advantage, Blue KC is taking this approach to the next level, emphasizing its belief in a strong doctor-patient relationship that delivers proactive, effective and convenient care.

“Lumeris provides the proven processes and services that Blue KC needs to effectively manage and maintain the best-in-market Medicare Advantage plans,” said Wilson. “Our partnership with Lumeris will enable us to achieve our goals of transforming healthcare delivery in Kansas City to value-based care models, and offering better outcomes to the area’s Medicare eligible.”

With assistance from Lumeris to improve care coordination, Blue KC will be in a position to meet the industry’s goals of the Triple Aim plus One: improved quality, cost, and patient plus physician satisfaction.

“By leveraging our experience and proven systems, we will actively partner with Blue KC to lower the cost of healthcare and increase operational efficiencies,” said Michael Long, chairman and CEO of Lumeris. “Our value-based health plan solutions will also position Blue KC membership to experience improved care coordination and quality of care.”

Blue Medicare Advantage plan details will be released on October 1, 2015.

Blue Cross and Blue Shield of Kansas City’s Blue Medicare Advantage is an HMO plan with a Medicare contract. Enrollment in Blue Medicare Advantage depends on contract renewal.

Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in Missouri and the only not-for-profit commercial health insurer in Kansas City, has been part of the Kansas City community since 1938. Blue Cross and Blue Shield of Kansas City provides health coverage services to more than one million residents in the greater Kansas City area, including Johnson and Wyandotte counties in Kansas and 30 counties in Northwest Missouri. Our mission: to use our role as the area's leading health insurer to provide affordable access to health care and to improve the health and wellness of our members. Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association. For more information on the company, visit its website at

Lumeris is a pioneer in population health management solutions. Through our operations, technology and consulting services, we enable healthcare organizations to successfully make the journey from volume- to value-based care. We help health systems create Population Health Services Organizations and define populations for risk. We empower providers and their accountable care teams with process improvement strategies, technology tools and clinical workflows to manage their patients and populations effectively. We work collaboratively with payers to ensure the right contracts, measures and incentives are in place to influence physician behavior and drive quality, cost and utilization performance. The depth and breadth of Lumeris’ solutions – combined with its decade of experience in value-based care – make the company an ideal partner for any healthcare organization seeking to transform its business and care-delivery model and remarkably improve its clinical and financial outcomes. For more information, call 1.888.586.3747 or visit


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Christopher Currington
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