LONG BEACH, California, November 9, 2020 – agilon health is pleased to announce that, together with its physician practice partners, it is participating in six Direct Contracting Entities effective Oct. 1, 2020. The Centers for Medicare & Medicaid Services (CMS) Innovation Center Direct Contracting model aims to reduce expenditures and improve quality of care for seniors in traditional Medicare. CMS announced that 60 entities are participating in the model at this time. agilon health and its partners represent the participation of approximately 500 primary care doctors providing care to more than 70,000 fee-for-service Medicare patients in seven states.

The Direct Contracting model is a voluntary demonstration project that changes the way that physicians and physician practices are paid, moving away from a fee-for-service system that incentivizes volume to a capitated model that rewards better health outcomes. The model seeks to align traditional Mcedicare and Medicare Advantage, creating efficiencies and reducing burden for physician practices. Furthermore, the ability to offer enhanced benefits and payment waivers gives participants, like agilon health and its partners, greater opportunities to coordinate care for seniors in traditional Medicare.

“COVID-19 has underscored the relative strength and importance of pre-paid models like Direct Contracting. agilon health and its physician practice partners are looking forward to playing a central role as innovators in care delivery for seniors in traditional Medicare,” said Steven Sell, Chief Executive Officer, agilon health.

Building on the momentum of agilon health’s value-based care partnership model covering more than 160,000 Medicare Advantage patients, the new Direct Contracting model will expand agilon health practice partners’ responsibility for total care to all of their seniors, regardless of coverage choices.   Leading independent physician practices, like Central Ohio Primary Care, who partner with agilon health, are invigorated and thriving as a result of models which allow them to move away from fee-for-service payments to patient-centric reimbursement mechanisms which prioritize optimizing the experience and health outcomes of older adults.  COPC has been committed to innovative value-based care models in both Medicare Advantage and traditional Medicare for many years.  With the introduction of Direct Contracting and through the agilon health partnership, COPC physicians can expand their ability to care for seniors holistically.  This is energizing to primary care physicians and will allow COPC to set the standard for quality, patient, and physician experience in the greater Central Ohio community.

 

About agilon health

agilon health is the only health-care company of its kind, empowering and partnering with doctors to lead the transformation of their practices toward a future that rewards bold action, market-leading growth and durable patient relationships. Through the power of a national community of like-minded physicians and an integrated operating platform, we are leading the reinvention of health care delivery.

A unique and practice-branded joint operating model developed with its physician partners allows practices to boldly design and launch a financially aligned total care model for Medicare Advantage patients, unifying the physician and patient experience.  The result: empowered physician leaders, thriving practices, healthier communities, and practicing physicians who are rewarded intrinsically and financially by spending the right amount of time with the right patients who get the right treatments.

Since its founding in 2016 , the agilon health community of physician partners has grown to 11 markets across 7 states.  Leading physician groups such as Austin Regional Clinic, Buffalo Medical Group, Central Ohio Primary Care, Preferred Primary Care Physicians, and Wilmington Health are collaborating through the agilon health platform. Today there are more than 160,000 Medicare Advantage members on the agilon health platform with 1,500 primary-care physicians. Visit www.agilonhealth.com.

 

About Central Ohio Primary Care

Central Ohio Primary Care (COPC) is the largest physician-owned primary care medical group in the United States. COPC was established in 1996 when a group of 33 physicians chose to focus more on the quality of patient care they were providing and less on the administrative paperwork. Today, they have over 445 physicians and 80 practice locations throughout central Ohio, along with a full-service laboratory, radiology, cardiac testing, physical therapy and hospitalist services, and several first-rate disease management programs.

 

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The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.