L

Lumeris

Value-based care management via PHSO platform

Overview

Lumeris provides value-based care management as a services operator for health systems and physician groups, offering technology, services, and risk management to shift from fee-for-service to value-based models. Its Population Health Services Organization (PHSO) combines an AI-powered platform called Tom with workflows and expertise to coordinate care, surface best next actions like screenings, and reduce administrative burden. It differentiates itself through risk-sharing partnerships with providers and payers and by leveraging Essence Healthcare’s proven value-based care approach at scale, managing over $13 billion in medical spend and serving more than a million patients. Its goal is to expand the adoption of value-based care by forming broader risk-based partnerships that improve clinical outcomes while controlling costs.

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About Lumeris

Simplify's Rating
Why Lumeris is rated
C+
Rated B on Competitive Edge
Rated B on Growth Potential
Rated D+ on Differentiation

Industries

Data & AnalyticsEnterprise SoftwareAI & Machine LearningHealthcare

Company Size

1,001-5,000

Company Stage

Late Stage VC

Total Funding

$507M

Headquarters

Maryland Heights, MO

Founded

2001

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What believers are saying

  • On October 20, 2026, Lumeris hired Chuck Saunders to scale value-based care and Tom.
  • July 2026 launches added symptom-checking, Ask Tom, and native audio to Tom.
  • TIME named Lumeris a top 2026 health tech company, supporting enterprise sales credibility.

What critics are saying

  • A 2017 whistleblower case over Medicare risk coding remains pending in federal court.
  • The July 15 ruling denying dismissal keeps Essence and Lumeris exposed through 2027.
  • Tom's differentiation depends on one platform; a major clinical or compliance failure would cripple trust.

What makes Lumeris unique

  • Tom embeds AI workflows directly into primary care teams, not standalone analytics.
  • Hackensack Meridian expanded its partnership to Traditional Medicare after $40 million savings in 2024.
  • Lumeris combines managed services, risk sharing, and clinical content across Medicare, Medicaid, and commercial.

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Funding

Total Funding

$507M

Above

Industry Average

Funded Over

5 Rounds

Notable Investors:
Late VC funding comparison data is currently unavailable. We're working to provide this information soon!
Late VC Funding Comparison Coming Soon

Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Disability Insurance
  • Health Savings Account/Flexible Spending Account
  • Unlimited Paid Time Off
  • Flexible Work Hours
  • Paid Vacation
  • Paid Sick Leave
  • Paid Holidays
  • Sabbatical Leave

Growth & Insights and Company News

6 month growth

0%

1 year growth

0%

2 year growth

0%
Yahoo Finance
Oct 20th, 2026
Lumeris hires ex-Integra Connect CEO Charles Saunders to lead value-based care and AI platform Tom

Lumeris, a health care technology and services company, has hired Dr. Charles "Chuck" Saunders as chief clinical transformation officer and president of Value-Based Care Enablement. The company announced the appointment on October 20, 2026. Saunders will lead the business unit that helps health systems and physicians improve clinical and financial results under value-based care. He will also oversee clinical leadership for Tom™, Lumeris' AI-powered Primary Care as a Service™ platform. Saunders most recently served as chief executive officer of Integra Connect. He founded Healthagen, Aetna's population health business, and was earlier chief executive of Broadlane and chief medical officer of Healtheon/WebMD. "There are few leaders who understand value-based care as deeply as he does," said Mike Long, Lumeris' chairman and chief executive officer.

PR Newswire
Jul 21st, 2026
Lumeris partners with Schmitt-Thompson to strengthen Tom™ AI platform with evidence-based telehealth triage guidance

Lumeris has partnered with Schmitt-Thompson Clinical Content (STCC) to integrate evidence-based clinical triage content into Tom, its AI-powered Primary Care as a Service platform. The collaboration aims to strengthen Tom's symptom-checking capability by combining conversational patient engagement with STCC's clinical guidance. The enhanced feature helps patients with chronic conditions navigate symptoms between appointments whilst supporting care teams in identifying those requiring additional attention. Following interactions, Tom generates structured summaries with prioritisation guidance to assist clinical workflows. STCC provides telehealth triage guidelines to over 400 health systems and 10,000 physician practices across North America. Lumeris, founded in 2010 and headquartered in St. Louis and Cambridge, Massachusetts, employs more than 1,200 staff.

PR Newswire
Jun 16th, 2026
Lumeris launches Tom AI symptom checker to support high-risk patients between primary care visits

Lumeris has launched a symptom-checking capability within Tom, its AI-powered Primary Care as a Service platform, to support high-risk patients between primary care appointments. The feature enables patients with chronic conditions to report symptoms and ask health-related questions through conversational interactions. Powered by Google's CX Agent Studio and Gemini, the capability generates structured summaries with prioritisation guidance to help care teams assess patient needs and determine appropriate interventions. The system aims to prevent delayed care or unnecessary visits to higher-acuity settings. The feature is currently being used by a Medicare Advantage plan serving high-risk members, with broader availability planned later this year. It complements recent Tom platform additions including conversational analytics and real-time voice interactions. Founded in 2010, St. Louis-based Lumeris employs over 1,200 healthcare specialists.

PR Newswire
Apr 22nd, 2026
Lumeris launches native audio for Tom AI platform to address US primary care shortage

Lumeris has introduced native audio capabilities for Tom, its AI-powered Primary Care as a Service platform, enabling real-time speech-to-speech interactions with patients. Built using Gemini's native audio technology, the functionality aims to create more natural patient conversations with reduced latency and improved accuracy. The upgrade addresses America's primary care shortage, where nearly 100 million adults lack access and a shortage of 90,000 physicians is projected within the decade. Native audio allows patients to engage through voice with improved turn-taking, noise handling, and planned multilingual support. The technology is integrated across Tom's communication channels, including phone and mobile applications, supporting continuous AI-enabled primary care whilst keeping care teams in control. Lumeris, founded in 2010, employs over 1,200 staff across engineering, clinical and healthcare specialties.

PR Newswire
Mar 18th, 2026
Lumeris launches Ask Tom, giving health leaders conversational AI access to enterprise data

Lumeris has launched Ask Tom, an AI-powered analytics capability that gives health system leaders conversational access to enterprise data through its Tom Primary Care as a Service platform. The tool allows users to query complex healthcare data in plain English and receive instant answers, visualisations and recommendations. Ask Tom aggregates data from clinical, claims, pharmacy and social determinants sources to create a comprehensive view of patients and populations. The platform features agentic capabilities that continuously monitor enterprise data, detect anomalies and surface improvement opportunities. The launch addresses mounting pressure in US primary care, where nearly 100 million adults lack access and a shortage of 90,000 physicians is projected over the next decade. Ask Tom is currently available in limited preview, with broader availability planned for 2026.

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