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Better care
through better
coordination.

Overview

Essence Medicare Partners is an Accountable Care Organization, or “ACO,” authorized by Medicare to help coordinate the healthcare of Medicare beneficiaries through Medicare’s ACO REACH program. The ACO REACH (Realizing Equity, Access, and Community Health) model is designed to improve the quality of care for people with Medicare through better care coordination and connecting health care providers and beneficiaries, including those beneficiaries who are underserved. Through this program, the healthcare providers, clinical teams and administrative leadership of Essence Medicare Partners are working closely together to provide Medicare patients a coordinated healthcare experience that is catered to each patients’ individual needs. We are focused on improving the quality-of-care patients receive while also reducing their costs by providing access to services, resources, and programs that focus on helping patients stay healthy and better manage any chronic health conditions they may have.

Additional benefits may be available to you based on your alignment to a participating provider in our ACO. Benefits may include home health services and direct or accelerated transfer to Skilled Nursing Facilities.


Eligibility Requirements

You may be eligible to participate in the program if you meet the following criteria:

  • You are enrolled in both Medicare Parts A and B and have Medicare as your primary health insurance
  • You are a resident of the United States and live in one of our qualified service areas
  • You are not currently enrolled in a Medicare Advantage plan, Medicare Cost Plan under section 1876, PACE organization or other Medicare health plan besides Original Medicare (Parts A and B).

How to Participate

If you are eligible for the program, there are several ways you can participate:

If you regularly see a doctor who is part of our provider network, you may have been auto-enrolled in the program by Medicare. If you have been auto-enrolled, you will receive a welcome letter in the mail from us.

OR

You also have the option to sign up by choosing a doctor in our network and completing a Voluntary Alignment form. Find out how to complete your Voluntary Alignment form.

If you are eligible for the program, there are several ways you can participate:

If you regularly see a doctor who is part of our provider network, you may have been auto-enrolled in the program by Medicare. If you have been auto-enrolled, you will receive a welcome letter in the mail from us.

You also have the option to sign up by choosing a doctor in our network and completing a Voluntary Alignment form. Find out how to complete your Voluntary Alignment form.


Our Providers

To see a list of all the participating providers in our program, select the directory below that corresponds with your current city of residence.


Common Questions

Is this a health plan?
No. This is a special program for people enrolled in Original Medicare (Parts A & B). If you elect to participate in our program, you will continue to receive the same Medicare benefits that you do today.

Can I see any doctor?
Yes. You may still see any doctor who accepts Medicare.

Can I participate if I have a Medicare Supplement policy?
Yes. If you enrolled in Original Medicare and also have a Medicare Supplement policy, you can still participate in the program.


About Us

Esse Health ACO, LLC

Mailing Address

Esse Health ACO, LLC
P.O. Box 5098
Troy, MI 48007

Corporate Address

Esse Health ACO, LLC
12655 Olive Blvd 4th Floor
St. Louis, MO 63141

Primary Contact

Joseph Satorius
Administrative Officer
jsatorius@essencemp.com

If you are a Medicare patient and have questions regarding our program, call 1-833-347-5760 (TTY: 711).

Clinical & Administrative Leadership

Joseph Satorius – Administrative Officer – LGHC

Rishi Sud, MD – Medical Director – Esse Health

Britton Whitbeck – Compliance Officer – LGHC

Jean-Claude Saghbini – Technology Officer – LGHC

Erin Venable – Finance Officer – LGHC

Governing Body

All voting members

David Hartenbach, MD – Board Chairman and Physician – Esse Health

Robert Curtin, MD – Board Member and Physician – Esse Health

Patrick Nakashima-Moran, MD – Board Member and Physician – Esse Health

Phil Berwick – Beneficiary Representative – Retired

Mike Long – Chief Executive Officer – Lumeris

Chuck Willey, MD – Board Member & Physician – Vicinia Health

Jim Althoff, MD – Board Member & Physician – Vicinia Health

Richard Berliner – Consumer Advocate – Retired

Joint Ventures

American Multispecialty Group, Inc, (d/b/a Esse Health), a medical group consisting of Participating and Preferred Providers, holds an ownership interest in Essence Medicare Partners.


Public Reporting

  • 2023 CMS Total Quality Score
    74.12%
  • Shared Savings
    $26,016,654.61
  • Shared Savings Investments
    42%
  • Shared Savings Distributions
    58%
  • Risk-Standardized, All Condition Readmission
    15.40
  • All-Cause Unplanned Admissions for Patients with Multiple
    Chronic Conditions

    36.48
  • Timely Follow-Up After Acute Exacerbations of Chronic
    Conditions

    74.14
  • CAHPS
    0.90

CAHPS Survey Results

  • Getting Timely Appointments, Care, and Information
    85.43
  • How Well Providers Communicate
    94.58
  • Care Coordination
    87.53
  • Shared Decision-Making
    64.69
  • Patient Rating of Provider
    92.94
  • Courteous and Helpful Office Staff
    94.85
  • Health Promotion and Education
    61.77
  • Stewardship of Patient Resources
    27.02