BJC Medical Group Joins Essence Healthcare Provider Network

National leaders in accountable care partner to deliver higher quality, more affordable care to St. Louis-area Medicare beneficiaries

ST. LOUIS--(BUSINESS WIRE)--Essence Healthcare announced today the expansion of its relationship with BJC HealthCare, with the addition of BJC Medical Group to the Essence provider network. The physicians will join the network January 1, 2013, giving Essence health plan members additional physician choices throughout the St. Louis area.

“As a provider of primary and specialty care physicians, it is important for us to ensure patients can find or continue care with the type of doctor they need, in a convenient location with a broad selection of insurance coverage.”

“One of the keys to our success at Essence is the fact that we carefully select the physicians and hospitals in our network,” said Richard Jones, President and CEO of Essence Healthcare. “The physicians, nurses and hospitals of BJC HealthCare have earned a national reputation for delivering high-quality care, and we couldn’t be more excited to welcome BJC Medical Group to the Essence family.”

The partnership between BJC HealthCare and Essence marks the coming together of two of the region’s most progressive health care organizations. Both are leaders in the national accountable care movement, implementing new and innovative technologies, processes and methods that help improve the quality of care, reduce costs and maximize patient satisfaction.

BJC HealthCare was the only provider in the St. Louis area to be selected as an initial participant in the Center for Medicare and Medicaid Services’ accountable care organization program. Essence Healthcare is also at the forefront of the accountable care movement, having partnered with local doctors to establish the nation’s first accountable delivery system. Essence’s unique and collaborative approach has yielded positive results, earning the health plan the highest rating among Medicare Advantage plans in the St. Louis area. The Essence model is now being emulated and adopted by other health care organizations across the country.

Based on Essence’s success in accountable care, the company launched Lumeris, which shares the information technology and methods Essence originally developed with other health care organizations that seek to adopt more accountable models of care. BJC Medical Group physicians will be leveraging the information technology and tools from Lumeris as they care for Essence members.

“BJC Medical Group is pleased to be expanding the selection of Medicare Advantage plan choices for our patients in 2013,” said David Knocke, BJC Medical Group president. “As a provider of primary and specialty care physicians, it is important for us to ensure patients can find or continue care with the type of doctor they need, in a convenient location with a broad selection of insurance coverage.”

BJC Medical Group employs more than 300 physicians, nurse practitioners and physician assistants with a variety of medical specialties, including allergy, audiology, breast surgery, cardiology, colorectal surgery, electrophysiology, endocrinology, family medicine, gastroenterology, gerontology, gynecology, hospitalist, infectious disease, internal medicine, interventional cardiology, neurology, orthopedic and general surgery, otolaryngology, psychiatry, pulmonology, radiation oncology, rheumatology and vascular surgery. BJC Medical Group serves patients in nearly 100 practice locations.

ABOUT ESSENCE HEALTHCARE

Essence Healthcare offers people with Medicare comprehensive and affordable health insurance that focuses on wellness, care coordination and personal service. Essence’s Medicare Advantage HMOs bundle hospital, medical and prescription drug coverage together into one plan with one affordable monthly premium, and include additional benefits not covered under the Original Medicare program. Essence’s Medicare Advantage plans are designed and directed in partnership with local doctors, and are among the nation’s highest rated according to the federal agency that administers Medicare.

Essence Healthcare is a Medicare Advantage organization with a Medicare contract. The star rating referenced in this announcement is specific to Essence contract H2610 for plan year 2013. The superlatives “top-rated” and “highly rated” are substantiated by this star rating. Plan performance star ratings are assessed each year and may change from one year to the next. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Benefits, formulary, pharmacy network, premium and/or copayments or coinsurance may change each year.

ABOUT BJC HEALTHCARE

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. With net revenue of $3.6 billion, BJC serves urban, suburban and rural communities; and includes 13 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

ABOUT LUMERIS

Lumeris provides the information technology, guidance and operational services necessary for hospitals and health plans to transform their organizations into high-performing accountable delivery systems. Our revolutionary technology platform for accountable care integrates data from disparate systems across the continuum of care, provides complete visibility into the clinical and financial performance of an enterprise and delivers applications and information to key stakeholders at the point of thought. This improves coordination and enables timely value-based health care decisions that lead to optimal health and cost outcomes. The depth and breadth of our solutions — combined with the company’s extensive real-world experience in accountable care — make Lumeris the ideal partner for any health care organization seeking the significant benefits of a better connected, aligned and informed accountable delivery system.