What Lumeris does

Lumeris is a physician-founded healthcare technology company headquartered in Maryland Heights, Missouri, with operations across St. Louis, Boston, and Cambridge, and approximately 1,200 employees. The company provides an AI-powered Primary Care as a Service (PCaaS) platform branded Tom™, which aggregates clinical, claims, pharmacy, and social determinants of health data across 30 billion-plus clinical data points and 219+ payer and EHR pipelines, ingesting roughly $90 billion in claims. Tom functions as an agentic AI member of the care team, autonomously executing patient outreach for preventive screenings, chronic condition check-ins for diabetes and hypertension, symptom assessment, care coordination, and EHR documentation. The platform is built on Google Cloud's Gemini models (Flash, Chirp3-HD, Gemini Live API), uses FHIR APIs for real-time clinical data exchange, and writes structured data back into Epic and other EHRs. Modular capabilities include Ask Tom (agentic analytics for health system leaders), Native Audio for voice-based patient interactions, and Tom Symptom-Checking for between-visit engagement with high-risk patients. The platform currently supports 1.4 million lives across Medicare Advantage, Traditional Medicare, Medicaid, and Commercial value-based care arrangements, with $9.3 billion-plus in medical spend under management. Lumeris was founded in 2010 by Tom Doerr (1957-2019), in whose honor the platform was named.

Lumeris sells to large U.S. health systems, physician groups, and payers through an enterprise field-sales motion, deploying embedded operational teams that share financial risk with partners under multi-year value-based care agreements. Reported revenue for 2024 is $3 billion, though this figure is likely dominated by premium pass-through from Essence Healthcare, a wholly-owned Medicare Advantage subsidiary that holds a 4.5-star CMS rating for 2026. Core revenue streams include platform and technology subscriptions, value-based care enablement services with shared-savings economics, AI analytics, and Medicare Advantage premium revenue. Disclosed customer outcomes include 20-30% reductions in total cost of care, $100+ PMPM savings in Medicare Advantage, 94% average quality scores across ACO partners, and a 139% increase in negotiated upside-share payouts over three years. Major customers include Hackensack Meridian Health, whose 700+ doctor ACO generated $40 million in savings and an $18 million shared-savings payout in 2024.

The company is private, backed by Kleiner Perkins, Deerfield Management, Endeavor Health, Sandbox Industries, and Blue Cross Blue Shield Association, and is led by Chairman and CEO W. Michael Long (former CEO of Healtheon/WebMD and Move/Realtor.com) and EVP/Chief Medical & Commercial Officer Dr. David Carmouche, who was concurrently appointed to the HHS and CMS Healthcare Advisory Committee. Recent strategic moves include the 2024 $100M+ Form D capital raise, the February 2025 launch of the Tom platform, the June 2025 Google Cloud strategic partnership, the November 2025 launch of the Collaborative for Healthy Rural America (CHRA) with Teladoc, Deloitte, Nuna, and Unite Us, and the 2026 expansions of Tom product surface (Ask Tom, Native Audio, Symptom-Checking). The company is pursuing a clear growth path into rural health transformation, government and state-level CMS contracts, and adjacent product lines such as wearable data integration (Oura partnership) and food-as-medicine (Instacart Health integration via CHRA).

Name

Lumeris

Legal name

Lumeris Group Holdings Corporation

Website

https://lumeris.com

Company type

Private

Founded year

2010

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Lumeris is a physician-founded healthcare technology company that provides Tom™, an AI-powered Primary Care as a Service platform, serving U.S. health systems, physician groups, payers, and patients in value-based care arrangements, with embedded operations and a wholly-owned Medicare Advantage subsidiary.

Ownership category

akta.pro rank

Product category

Healthcare Value-Based Care Platform

NAICS

Computer Systems Design and Related Services (54151), Custom Computer Programming Services (541511), Services for the Elderly and Persons with Disabilities (624120)

SIC

Services-Health Services (8000), Services-Prepackaged Software (7372), Services-Offices & Clinics Of Doctors Of Medicine (8011)

akta.pro primary industry

Patient Engagement, Education & Messaging Platforms (portal/CRM integrated) (HLALABAJ)

akta.pro secondary industries

Adherence, Reminders & Engagement Automation (Medication/Follow-up) (HLACAEAJ), Chronic Condition Virtual Care & Disease Management (Payer-Sponsored) (HLALACAE)

Keywords

• Value-based care platform
• Primary care software
• AI care orchestration
• Healthcare analytics platform
• Population health management

Headquarters

HQ city

St Louis

HQ country

United States

HQ region

North America

Offices4 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure, Supply Chain

Revenue model

1. Platform and Technology Services: Lumeris provides an AI-powered PCaaS platform (Tom) to health systems and provider groups operating in value-based care arrangements. Revenue is derived from technology platform fees, care management services, and analytics subscriptions under multi-year partnership agreements.
2. Essence Healthcare (Subsidiary Medicare Advantage Plan): Lumeris subsidiary Essence Healthcare operates a Medicare Advantage plan generating premium revenue from CMS. Essence Healthcare earned a 4.5-star CMS rating for 2026 and was named among the best-performing Medicare Advantage plans. Revenue is premium-based per member per month under at-risk payer contracts.
3. Value-Based Care Enablement Services: Lumeris generates revenue through comprehensive value-based care solutions combining people, process, and technology. Services include care quality and access solutions, documentation and coding, acute and post-acute orchestration, high-risk patient management, and foundational services. Revenue derived from shared savings payouts, performance-based contracts, and managed services fees. Health system partners have achieved $100+ PMPM savings in Medicare Advantage.
4. AI-Powered Analytics (Ask Tom): Agentic analytics capability delivering conversational access to enterprise healthcare data. Part of the broader platform subscription or add-on analytics service for health system leaders querying clinical, claims, pharmacy, and operational performance data.

Go-to-market motion2 records

Distribution channels6 records

Marketing channels7 records

Core offering

Lumeris sells an AI-powered Primary Care as a Service (PCaaS) platform called Tom that autonomously executes care management tasks, aggregates clinical, claims, pharmacy and social determinants data, and orchestrates patient outreach, chronic disease management and preventive care. The company pairs the Tom platform with embedded operational teams, value-based care consulting, and shared-risk partnership agreements for health systems, physician groups, and payers. It also operates a subsidiary Medicare Advantage plan (Essence Healthcare) that serves as a live deployment of the platform.

Product overview

Lumeris offers a unified Primary Care as a Service (PCaaS) platform centered on Tom™, its AI-powered operating system for primary care. The platform combines Tom (the core AI engine providing autonomous care coordination, patient outreach, and clinical decision support) with specific capabilities including Native Audio (real-time speech-to-speech interactions), Ask Tom (conversational analytics for health system leaders), and Symptom-Checking (AI-powered between-visit patient symptom assessment). All capabilities are powered by Google Cloud's Gemini technology and integrate with existing EHR systems to deliver continuous, proactive primary care that addresses the U.S. physician shortage and expands access for patients.

Differentiator

Problem solved

Functional benefit

Brands

• Tom™: AI-powered Primary Care as a Service platform that autonomously executes care management tasks and integrates social determinants of health.
• Primary Care as a Service (PCaaS)

Products and services

• Tom (AI Operating System for Primary Care) Tom is Lumeris's core AI-powered operating system for primary care, functioning as an agentic AI member of the care team. It autonomously executes care management tasks including patient outreach, chronic condition monitoring, preventive screenings, care coordination, and clinical decision support for health systems and physician groups operating under value-based care contracts.
• Ask Tom Ask Tom is an agentic analytics capability within the Tom platform that aggregates clinical, claims, pharmacy, and social determinants data to enable health system leaders to query performance metrics in plain English and receive AI-generated answers, visualizations, and recommendations in seconds.
• Native Audio for Tom Native Audio for Tom enables real-time speech-to-speech AI patient interactions built with Google Cloud's Gemini native audio infrastructure, allowing voice-based patient engagement to address primary care access gaps, particularly for rural and elderly populations.
• Tom Symptom-Checking Capability Tom Symptom-Checking is an AI-powered capability within the Tom platform that enables patients with complex health needs to report symptoms and receive guidance through natural conversational interactions between primary care visits, generating structured summaries with prioritization guidance for care teams.
• Essence Healthcare Medicare Advantage Plan Essence Healthcare is Lumeris's subsidiary Medicare Advantage plan generating premium revenue from CMS, operating in Illinois, Missouri, Arkansas, Kentucky, and Indiana. It functions as a live deployment of the Tom platform and proof-of-concept for value-based care delivery.

Quantifiable outcome

• 20–30% reduction in total cost of care for health system partners
• +8 more outcomes

Named customers3 records

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

AI capability11 records

Feature9 records

Partnerships

Twelve partnerships are on record, tiered core and minor.

• Essence HealthcarecoreStrategic or Co-development Partner · 9 June 2026Essence Healthcare, a Lumeris subsidiary Medicare Advantage plan, partnered with Oura to expand the Oura Ring benefit from wellness support to proactive clinical engagement. The partnership uses nighttime breathing insights from Oura's Oura Ring to help physicians proactively identify Medicare Advantage members at risk for obstructive sleep apnea. The workflow integrates Oura sleep data, Lumeris' Tom platform, and physician-led clinical review for personalized outreach across Essence's plans in Illinois, Missouri, Arkansas, Kentucky, and Indiana.
• InstacartminorStrategic or Co-development Partner · 12 May 2026Instacart joined the Collaborative for Healthy Rural America (CHRA), integrating its food delivery capabilities (Instacart Health) into coordinated care models alongside existing CHRA members including Deloitte, Lumeris, Nuna, Teladoc Health, and Unite Us. The partnership aims to expand access to nutritious food to address chronic disease in rural communities. States will report Year 1 progress to CMS in October 2026.
• Ochsner HealthcoreStrategic or Co-development Partner · 9 April 2026Ochsner Health is hosting Lumeris at its Strategic Partner Summit and collaborated on a webinar 'Beyond the Visit: How Ochsner Health is Using AI to Transform Primary Care Delivery' focused on how health systems are deploying AI to address primary care workforce challenges and improve care delivery.
• Hackensack Meridian HealthcoreStrategic or Co-development Partner · 27 January 2026Hackensack Meridian Health and Lumeris expanded their value-based care partnership to include Traditional Medicare beneficiaries through the CMS Medicare Shared Savings Program. The existing collaboration covers Commercial and Medicare Advantage programs. Lumeris deploys its AI-powered Tom platform to support physician-led care coordination and improve outcomes for Medicare patients across New Jersey. Hackensack Meridian Health's ACO of over 700 doctors achieved $40 million in total healthcare savings and an 87.27% quality score in 2024, earning a shared savings payout of over $18 million.
• AVIAminorChannel Partner/ Reseller/ Distributor · 18 December 2025AVIA announced an expansion of its Agentic AI portfolio with a second cohort of health systems and launched Nexus Catalyst, a 12-week program to promote AI adoption in healthcare. The initiative focuses on improving primary care operations through collaboration with solution providers including Lumeris.
• Teladoc HealthcoreStrategic or Co-development Partner · 3 November 2025Lumeris and Teladoc co-founded the Collaborative for Healthy Rural America (CHRA), a coalition to help states accelerate CMS Rural Health Transformation Program efforts and address critical gaps in rural healthcare access. The coalition delivers an AI-enabled interoperable operating platform connecting patients and clinicians, with a goal to expand access nationwide within six months. Teladoc contributes virtual care network capabilities to the CHRA coalition alongside Lumeris, Deloitte, Nuna, and Unite Us.
• Deloitte ConsultingcoreImplementation/ SI/ Consulting Partner · 3 November 2025Deloitte Consulting is a founding member of the Collaborative for Healthy Rural America (CHRA) alongside Lumeris, Teladoc, Nuna, and Unite Us. Deloitte contributes its consulting capabilities to help states implement rural healthcare transformation initiatives funded through CMS cooperative agreements. The coalition aims to deliver scalable, technology-driven healthcare solutions to address provider shortages, hospital closures, and fragmented care in rural America.
• NunacoreStrategic or Co-development Partner · 3 November 2025Nuna is a founding member of the Collaborative for Healthy Rural America (CHRA) alongside Lumeris, Teladoc, Deloitte, and Unite Us. Nuna contributes to the coalition's mission of helping states accelerate rural health transformation efforts funded by CMS cooperative agreements. The coalition delivers an AI-enabled interoperable operating platform called Primary Care as a Service (PCaaS) to address critical healthcare access challenges in rural America.
• Unite UscoreStrategic or Co-development Partner · 3 November 2025Unite Us is a founding member of the Collaborative for Healthy Rural America (CHRA) alongside Lumeris, Teladoc, Deloitte, and Nuna. Unite Us contributes social support integration and coordinated care platform capabilities to the coalition, supporting state-led rural health transformation initiatives funded by CMS and addressing social determinants of health in underserved rural communities.
• Google CloudcoreTechnology or Integration · 13 June 2025Lumeris and Google Cloud entered a strategic partnership to address the significant primary care shortage in the United States, building Lumeris' AI-powered Tom platform to bridge an estimated gap between 2.5 billion hours of annual care demand and fewer than 500 million available hours. The platform leverages Google Cloud models including Gemini Flash and Chirp3-HD to autonomously execute clinical actions, reduce administrative burdens, and improve care accessibility across Medicare Advantage, Traditional Medicare, Medicaid, and Commercial populations. Lumeris is also using Gemini Live API on Vertex AI for real-time multimodal conversational AI capabilities.
• MIT Computational Biology LabcoreStrategic or Co-development Partner · 29 May 2025Lumeris partnered with MIT's Computational Biology Lab to enhance its AI-powered primary care platform Tom through advanced computational models. The collaboration aims to improve personalized care especially for underserved populations by integrating AI and bioinformatics into healthcare workflows. This initiative addresses the primary care access gap in the United States, which exceeds 2 billion hours annually.
• ŌURAcoreTechnology or Integration · 19 February 2025Oura partnered with Lumeris to develop AI-powered primary care solutions aimed at expanding capacity, reducing administrative burdens, and improving patient access through innovative health insights and services. The collaboration integrates Oura Ring's sleep and biometric data (nighttime breathing insights) with Lumeris' Tom platform for proactive clinical engagement. The partnership was expanded in 2026 to include a clinical workflow that uses Oura Ring data to identify Medicare Advantage members at risk for obstructive sleep apnea, integrating sleep data with physician-led clinical review for personalized outreach across Essence Healthcare's plans in Illinois, Missouri, Arkansas, Kentucky, and Indiana.

Scale indicators22 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Evolent Health: Evolent Health provides value-based care enablement and specialty care management for health plans and providers, directly competing with Lumeris in VBC operating partnerships and risk-bearing arrangements for health systems.
• agilon health: agilon health partners with primary care physician groups to manage Medicare Advantage populations under value-based contracts, sharing the same core customer (health systems/PCPs in MA risk arrangements) and similar at-risk economics as Lumeris.
• Privia Health: Privia Health operates a national medical group and physician enablement platform focused on value-based care, with multi-payer VBC contracts and ACO partnerships that overlap with Lumeris's health system and physician group target segments.
• Aledade: Aledade partners with independent primary care practices and health systems to build ACOs and risk-bearing arrangements across MA, MSSP, and Commercial populations, directly overlapping with Lumeris's PCaaS physician enablement thesis.
• VillageMD: VillageMD (a Walgreens Boots Alliance company) provides value-based primary care through owned clinics and provider partnerships, sharing Lumeris's PCP-anchored, risk-bearing, technology-augmented primary care thesis.
• Innovaccer: Innovaccer provides a healthcare data and AI platform for population health management and value-based care enablement, overlapping with Lumeris's Tom platform capabilities in EHR integration, analytics, and care orchestration.

Broad incumbents

• Oak Street Health (CVS Health): Oak Street Health, owned by CVS Health, operates a senior-focused primary care platform serving Medicare Advantage members, directly overlapping with Lumeris's Essence Healthcare MA member population and Tom-enabled physician practices.
• Health Catalyst: Health Catalyst is a healthcare data and analytics platform serving health systems with population health, cost, and quality analytics, overlapping with Lumeris's Ask Tom conversational analytics and broader data-orchestration layer.
• Humana CenterWell: Humana's CenterWell senior-focused primary care clinics deliver value-based primary care to MA members, overlapping with Lumeris's Essence Healthcare plan and Tom platform's senior chronic-disease management capabilities.

Emerging players

• Cohere Health: Cohere Health applies AI to utilization management and prior authorization workflows for payers and providers, intersecting with Lumeris's Tom platform in AI-driven clinical workflow automation, though focused on UM rather than primary care delivery.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks7 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/1046969
• Xx.com/Lumeris

Revenue estimate

Valuation estimate

Number of profiles

Profiles14 records

Subsidiaries1 record

Funding overview

Funding rounds7 records

Investors7 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A1 record

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Lumeris