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Former CMS Administrator, Mark McClellan acknowledges agilon health as the organization leading the value-based care transformation

In the January 2021 Medical Economics issue, Mark McClellan, MD, Ph.D., former CMS Administrator, and FDA Commissioner, now Director of the Duke-Margolis Center for Health Policy at Duke University, spoke with Chris Mazzolini about what a post-pandemic health care delivery system should look like and the role primary care physicians should hold in this system. Mr. McClellan recognized agilon health as the organization leading the value-based health care transformation and supporting like-minded primary care physicians in the endeavor. Read the full article below or here.

 

Medical Economics Journal, Medical Economics January 2021, Volume 98, Issue 01

January 12, 2021

Chris Mazzolini

Creating a post-COVID health care system

What should a post-pandemic health care delivery system look like? And what role should primary care physicians hold in this system?

The COVID-19 pandemic is a monumental challenge for the U.S. health care system. But it’s also a once-in-a-lifetime opportunity to shake up the status quo, which relies on a-fee for-service system that is outdated and leaves both physicians and patients wanting more.

What should a post-pandemic health care delivery system look like? And what role should primary care physicians hold in this system?

Medical Economics® sat down recently via Zoom with Mark McClellan, M.D., Ph.D., to discuss that opportunity. McClellan is a former CMS administrator and FDA commissioner, and now serves as director of the Duke-Margolis Center for Health Policy at Duke University. This transcript was edited for length and clarity.

Medical Economics®: How would you assess the performance of the health care system during COVID-19?

Mark McClellan: I think it’s been mixed. First of all, health professionals in this country have done an incredible job working under often very difficult conditions and a pandemic where we never seem to be able to get to full containment. So it’s continuing to be a heavy burden on health care workers all over the country as we keep seeing recurrent cases and continued heavy burdens on our health care system throughout hospitals and detecting cases and managing patients with COVID-19.

I’ve also been impressed with the progress that we’ve made on therapeutics. I’m glad that Remdesivir seems to be moving beyond a shortage, limited access stage and becoming more broadly available. And we’ve clearly learned a lot about how to manage severe cases. Where it’s been tougher is in just how well prepared and robust our health care systems are. At the beginning of the pandemic, we just weren’t well prepared for this. We faced shortages in everything from diagnostic testing to PPE, and that had big consequences for our ability to contain the spread.

Now, people have commented a lot about the relative weakness of the U.S. public health system. I’ve seen a lot of examples of health care organizations moving upstream and doing more testing and at-risk communities helping integrate with public health. That may be the best path forward for our country for the future, since we just don’t have a well-developed public health system.

And then finally, in terms of the way our health care system has responded, I’ve been particularly impressed with organizations that have already moved away from fee-for-service payments. Some of the organizations that are more advanced in capitated type models, those organizations didn’t have their revenue floor fall out from under them when utilization fell in March and April. They were already engaged in a lot of telehealth and longitudinal data management to monitor their higher risk patients. They had a relatively easy time adapting to what was needed in the pandemic, which was a shift towards early intervention with patients, managing risks, redesigning care to put an emphasis on sites of service that were more community- and home-based.

I hope those features of our health care system, the interaction with public health, the building on population- based, value-based care models are something that we can develop further as we get through the rest of this pandemic and move beyond. It would make for a much more resilient health care system, one that’s much easier on health professionals the next time around.

ME: What should that post COVID-19 health care delivery system look like? And how do we take the next step with value-based care?

McClellan: In Duke Margolis, we’ve been collaborating with a lot of organizations and experts around the country, including six former CMS administrators who have worked from different perspectives, Republican and Democrat, on value-based care and payment reforms, including organizations like Families USA that are very concerned about the well-being of lower- and middle-income families that have really struggled during the pandemic.

And it all comes back to changing the way that we support our health professionals so they have an easier job not only responding to the pandemic but delivering care that reflects the opportunities for keeping people out of the hospital, for early diagnosis, and for dealing with the root causes of health problems much better than we have in the past. You know, people have been talking about value-based care for a while and it I think the evidence confirms that it does support paying differently by designing care differently.

Working as teams, using longitudinal data systems, we can do a better job of keeping people out of the hospital, improving patient experience, avoiding complications, and even get some savings at the same time. It’s been slow going, but I’m hoping that this will be a time for some further progress. I think it’s something that health care providers are maybe a bit more open to after seeing their fee-for-service revenues go down.

From a patient standpoint, people really have appreciated not just the ability to set up a telehealth visit, but all these services being reorganized around them and meeting their needs. Things like phone calls to let them know their risk. Or if they do have symptoms or a problem, connecting 24/7 to a nurse practitioner who knows their care and their and their records. It’s just a better way of delivering care. Here in North Carolina, Blue Cross of North Carolina has implemented a program where they’re giving some of their primary care groups some additional payments to help them get through the pandemic, who haven’t had as much assistance as some of the hospitals from the CARES Act and other emergency funding.

So they’re getting some financial help right now. And in conjunction with that they’re planning to move into so-called advanced medical home models over the next couple of years. This was a strategic direction that Blue Cross wanted to move in anyway, to get to better care. But it’s a special opportunity to do it now with some of the savings from reduced utilization that we’ve seen over the last few months, channeled directly into strengthening the practices and helping them move into these better models.

And we’re seeing some other examples like that around the country. CMS is starting some new programs that permit some upfront payments to physicians as part of their direct contracting and primary care first models and retooled oncology care model and kidney care model. Many other private insurers are interested in the same kinds of approaches. So it does seem like an opportune time to reflect on what went wrong, and really try to advance some of these value-based care models.

ME: I’m wondering what you think the correct approach is to getting providers to embrace value-based care? There’s the carrot and there’s the stick, and we sort of applied both of them in different ways. I’m wondering what you think is the way to really get physicians and health systems to leap with both feet into value-based care?

McClellan: Yeah, there are carrots and sticks. And from my time at CMS, a lot of providers complained about too much paperwork. So obviously, the more this is carrot-incentive oriented, the better. I actually think that the challenge with MIPS is that it puts a lot of emphasis on some minor adjustments in fee-for-service. You still get paid on a fee-for-service basis. You still have to do all the billing, all the paperwork, and on top of that, you’ve got to make sure you’re reporting on all the measures and things like that. And some of the things that the metrics are intended to do, like avoid readmissions, or improve other aspects of quality, the fee-for- service system doesn’t really pay you that well to support.

So the kinds of reforms I think are more promising, and the ones that in recent CMS reports they’ve shown have led to more savings and bigger measurable improvements in care, are ones that do move a bit more away from fee-for-service. So for a primary care group, giving them a payment per person, as a medical home or direct contract payment, that they get up front, and that they can use to make new kinds of investments, restructuring their practice, moving towards more of a team-based approach to care, investing in new IT capabilities that they can use in collaboration with health plans and other community organizations to augment the scope of services they can provide to keep people healthy.

And it’s those shifts away from the fee-for-service hamster wheel that give providers a chance to take a step back and say, okay, how do I really want to design my practice, that I think can make the most difference. And we’re seeing those kinds of models, not just in primary care, but in oncology, and kidney care. Getting kidney patients out of the dialysis clinics, which are generally not associated with the best outcomes and instead using models that enable more dialysis at home. That just wasn’t possible under the old here’s-your-payment-for-each-dialysis-service approach. And same thing true for other areas of specialized care and for accountable care organizations, as well.

CMS has tried to take a step in a number of their major Alternative Payment Model programs recently, pushing a bit more towards bigger shifts away from fee-for-service. I get nervous when I hear terms like downside risk, but really the flip side of that is money that you get up front that you can spend on what you think is most important, not just money where you have to ask, “do I have to do this procedure, this visit, and document this MIPS measure in order to get it?”

So it’s those bigger shifts that I think are more promising. And the good news here too, is that there are more supports and more experience available for all types of providers, small and large, primary care and specialty, to understand better how they can succeed in these approaches. It’s something that we work on a lot at Duke Margolis. There are other large collaborations producing more examples of successes. Other programs that really can help providers that are interested in these models look at and understand what they need to do. It is some work but in terms of provider experience—the quality part of the quadruple aim that’s very important for practice sustainability, as well as patient experience and quality of care and outcomes — these really are, it is increasingly clear, better ways of delivering care.

ME: Primary care physicians often feel very undervalued. And they feel like they’re on the hamster wheel, maybe more than a lot of other specialties. What do you see as the ideal role for primary care in the health care system?

McClellan: They need to have a bigger role. That means more support for more enhanced kinds of primary care programs, the kinds of things I’ve just been talking about. They involve primary care physicians not just doing a couple of office visits a year, but really being the coordinators, or the integrators of better care models that include working with a team, a nurse who can help with ongoing chronic care management, a social worker who can help with root causes of patients not taking their medication, or having some kind of issue that keeps them from getting into the office when a checkup is needed. Working with someone in the community who can help them as well as be sort of a trusted voice.

What we’re really talking about is an enhanced primary care model that costs more money. And that’s why I think some of the major payers for value-based care models are trying to get there by really creating significant payments to the enhanced primary care groups that are more than what they would have gotten before. But it’s also not linked to fee-for-service, because all those things I just mentioned are not things that are paid for in fee for service but instead are related to additional capabilities for helping to manage patients more effectively, getting better results, keeping them at home more. And they typically come with some accountability around health outcomes for their population or experience for their population. And getting total cost of care down.

We saw a number of models tried in the 2000s and 2010s, that were kind of additional payments for primary care. And those were helpful, and they made a difference in terms of supporting these kinds of additional capabilities, strengthening the primary care offices. Unfortunately, especially if you count the additional payments to primary care, they didn’t generally show overall health care savings, at least in the first few years after they were implemented.

The models that have shown more of an effect are these kinds of direct contracting or advanced primary care models that are more like physician led ACOs where the physician groups do take on at least some limited accountability for the total cost of care for their patients. It gives them more opportunities for additional revenues when they keep patients out of the hospital, get them into more effective care models, use specialty care more efficiently. Bring costs down as well as improving outcomes.

There are more programs available that physicians can get engaged in, like Aledade Health or Agilon, to provide support for some of these additional capabilities. Or they can work with health plans and Medicare Advantage and the Blue Cross plan that I mentioned earlier. So those kinds of opportunities look very promising as a realistic path available increasingly now to primary care docs to take primary care reimbursement from the really low5% or thereabouts of spending in the US, up to 10% or more. If you count all the integrated services, the coordination with behavioral health, and so forth, it makes for what should be a much stronger, enhanced primary care for the future.

Download Issue: Medical Economics January 2021

2021-01-13T18:09:57-07:00January 13th, 2021|

agilon health Partner Innovation & Platform Updates – December 2020 Newsletter

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Partner Innovation & Platform Updates

Partner Leadership

Team Member Bulletin

Innovation on the agilon health Platform

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2020-12-14T13:22:58-07:00December 14th, 2020|

agilon health Applauds Additional Participation Options for Centers for Medicare & Medicaid Innovation Direct Contracting Initiative

 

LONG BEACH, California, December 4, 2020 – The Centers for Medicare & Medicaid Innovation announced an additional Geographic participation option for its Direct Contracting model. The new option will expand and advance the portfolio of accountable, coordinated care models offered for traditional Medicare patients.

The Direct Contracting model is a voluntary demonstration project that incentivizes better health outcomes for patients rather than the volume of services provided. The model seeks to align traditional Medicare and Medicare Advantage, creating efficiencies and reducing burden for physician practices. The model also gives physician practices additional tools to coordinate and improve care for seniors in traditional Medicare. The Geographic option will give physician practices additional mechanisms to participate in total cost of care risk models with additional features and benefits.

“The agency’s action yesterday is the next step forward in designing bold new care delivery and payment options in traditional Medicare that can improve care and lower costs in traditional Medicare” said Steven Sell, Chief Executive Officer, agilon health. “This participation option provides another opportunity to build on the success our partners have seen in value-based models including accountable care organizations, CPC Plus, and Medicare Advantage,” Sell concluded.

Earlier this year, agilon health announced that, together with its physician practice partners, it is participating in six Global Direct Contracting Entities effective October 1, 2020. The agilon health partners participating in the model represent approximately 500 primary care doctors providing care to more than 60,000 fee-for-service Medicare patients in seven states.

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 1,400 primary care physicians. Visit www.agilonhealth.com.

 

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2020-12-07T11:28:33-07:00December 4th, 2020|

agilon health Announces Participation in the Center for Medicare & Medicaid Services Innovation Center Direct Contracting Model

 

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.

 

2020-11-09T14:29:39-07:00November 9th, 2020|

Finding Your First Job in a time of COVID-19: The Seven Principles for Navigating the Physician Job Market in a Post-Pandemic World

Ben Kornitzer, MD
Chief Medical Officer, agilon health

So, you’re finishing residency this year. Congrats! Sort of. Chances are, you are $200K or more in debt. You’ve survived a pandemic, and probably have a few battle scars to show for it. And now you are starting to look for your first real job (as if 80-hour weeks and barely making minimum wage as a resident doesn’t qualify as a “real” job) in the most turbulent and unpredictable physician job market in generations.

With so much uncertainty — hospitals and clinics furloughing employees, elective surgeries cancelled, an economy on the brink of recession — how can you plan long-term career moves when everything around you is changing by the minute? You anticipate. You adapt. To quote the hockey great, Wayne Gretzky, “Don’t skate to where the puck has been, skate to where the puck is going to be.”

For those of you looking for your first job, there is no better time than the present to position yourself to succeed in a rapidly evolving health care landscape. If you can anticipate how health care is transforming, you can see past the chaos and chart your own career path.

So, what does the future hold? Looking into our crystal ball, here are seven factors to consider as you set sail to chart new waters:

1) Think outside the office: Of course, most patients will continue receiving care within the four walls of a clinic. Nothing can replace the diagnostic and therapeutic importance of face-to-face interactions with our patients. However, increasingly, health care is moving out of the office. Young tech-savvy patients expect care to be just as convenient as ordering the newest gadget online. At the same time, many of the highest risk patients are the ones who aren’t coming into the office, either because they are too infirm, unable, or simply disengaged. To stay relevant to these patients, and to prepare yourself for the “health care system of the future,” look for a medical practice that is just as committed to caring for patients outside the four walls of the medical office as inside.

2) Prepare for the “silver tsunami”: Over the next decade, the number of Americans over the age of 65 is expected to double. Among the painful lessons of the pandemic was just how vulnerable this population is. In the coming years, those over 65 will need dedicated physicians who can address the special care needs of an aging population, including geriatricians, behavioral health specialists, and a focus on end of life/palliative care. All physicians will increasingly be called upon to care for older Americans, and those physicians who embrace that challenge will not only be highly sought after, but will find a deep, meaningful calling.

3) Think outside the hospital: COVID-19 has exposed deep and unsustainable inefficiencies in hospital compensation. To cover huge infrastructure overhead, health systems went on a buying spree over the last decade, acquiring physician practices, especially around highly lucrative specialties like cardiology and oncology. In fact, starting in 2018, more physicians were employed by hospital systems than private physician practices. Now, with deep losses due to postponed elective surgeries, many hospitals systems are reporting record shortfalls. As more care is delivered in ambulatory settings, the future increasingly looks like it will be outside of the four walls of the hospital. Candidates who are prepared for care models of the future should hitch their wagons to practices that embrace community-based, outpatient care.

4) Get on the value side of the equation: It is estimated that almost $1 trillion of health care spending in the U.S. is considered “waste” (e.g., duplicative testing, avoidable admissions, medical mistakes, low value testing and procedures, etc.). Considering that 18% of gross domestic product in the U.S. goes to health care, one doesn’t need to be an economist to know that this wasteful model of care is unsustainable. Increasingly, the government, insurance companies, employers, and patients are demanding higher value for their health care dollars. As our country transitions from a broken fee-for-service model to a model that focuses on value, physicians who can deliver the highest quality, most efficient care will be positioned to win. Success is not measured by how many patients you see in a day. Rather, it’s about your patient outcomes, and efficiently using resources to enhance those outcomes. Look closely for practices that don’t just pay lip service to catchphrases like “value-based care“ or “population health,” but that fully embrace the future by taking on meaningful financial risk for their patients’ care. And equally important, find a practice that rewards physicians for the service they provide patients — a practice where 20% of a physician’s compensation is tied to the value and quality of care provided.

5) Patient relationships cannot be replaced: COVID-19 has also accelerated the pace of disruption in health care. Retail stores are launching walk-in clinics and setting up kiosks to connect remotely with providers. Tech companies are advertising smartwatches that can track O2 saturation and heart rhythm. No doubt, the amount of money and technology being thrown at health care will only increase, but nothing can replace the importance of the doctor-patient relationship — it is our greatest currency as healers. In a health care world that changes day-to-day, find a practice where you can develop and sustain long-term relationships with patients and where your patients are at the center of everything you do.

6) Medicine is a team sport: The days of the physician as a solitary genius are quickly receding in the rearview mirror (apologies to fans of the TV show “House”). As medicine becomes more and more complex, quality patient care depends on teams that work well together. Seek out practices that have a culture of true collaboration, where physicians work hand-in-hand with colleagues across disciplines, including pharmacists, social workers, health coaches, navigators, behavioral health specialists, RNs, NPs, and PAs.

7) Follow your passions: After months stuck in a COVID-19 bubble (and years of training), perhaps this strange wrinkle in the space-time continuum will give you a chance to hit the pause button and reflect on what truly matters to you. You’ve spent countless years studying, training, and caring for sick patients during overnight shifts on hospital wards. At the end of the day, what will sustain you through the ups and downs of a medical career is the meaning you find in caring for others. Follow your passions. Make a difference in the world.

Dr. Benjamin Kornitzer is the Chief Medical Officer at agilon health. He is board-certified in internal medicine and his clinical practice focuses on primary care for high-risk, home-bound older adults.

Click here to read this article that appeared in Doximity.

Click here to read the article on KevinMD.com.

 

2020-12-01T11:24:05-07:00October 26th, 2020|

agilon health is excited to welcome Buffalo Medical Group and offers a new population health model to the Buffalo area seniors

 

Buffalo Medical Group LogoMedicare beneficiaries considering 2021 Medicare Advantage plans now have a new reason to take a closer look: an innovative, Buffalo-based population health model that features the leading trusted local medical group providing services designed to improve the quality, value, and patient experience of Medicare Advantage patients.

Buffalo Medical Group is teaming up with five of the areas local and national Medicare Advantage plans to offer a new population health model, Senior Care Advantage ONE. A list of participating health plans can be found at www.SeniorCareAdvantageONE.com. Medicare beneficiaries can explore the benefits offered by these plans during the Medicare Annual Election Period from Oct. 15 through Dec. 7.

Buffalo Medical Group (“BMG”) continues its commitment to purpose-built care for seniors through this innovative model. Patients covered by participating Medicare Advantage plans can secure appointments, either in-person or virtually, within two weeks at all BMG locations. BMG seniors are also enjoying a commitment to preventative care and services which are unparalleled throughout the community, especially during these extraordinary times. As such, over 85% of seniors with a BMG PCP will undergo an annual wellness visit in 2020 and are benefitting from more time with their physician and a comprehensive approach to their health and wellbeing.

The two-county area is populated by 252,662 Medicare beneficiaries, according to 2020 governmental demographic figures. About 63 percent were enrolled in Medicare Advantage plans.

The goal is to offer high quality care by providing the right care at the right times in the right locations, with a focus on preventing illnesses from occurring or worsening, explained John Notaro, MD, Medical Director of SCAONE and a primary care physician with Buffalo Medical Group. “If patients stay healthier, they are less likely to require costly emergency care or hospitalizations. Better coordination will be safer for patients and lead to less duplication of testing, such as unnecessary MRIs, X-rays, or overprescribing medications that can conflict with each other.”

Seniors Selecting Medicare Advantage Coverage is Accelerating
A 2020 Study from the Better Medicare Alliance found that Medicare Advantage patients save $1,598 over those with traditional Medicare. These patients also report 99% satisfaction with the care they receive under their Medicare Advantage plans and have 78% more plans to choose from nationally than they did five years ago. Because of Medicare Advantage coverage offers more benefits for the money, seniors are increasingly selecting Medicare Advantage coverage over traditional Medicare. In fact, experts predict that the number of Medicare Advantage-covered seniors will double by 2029. By collaborating with five Medicare Advantage plans in Buffalo, BMG is providing patients with the opportunity to save money and have more choice than ever in terms of the Medicare Advantage plans contracted with the practice.

For more information about SCAONE, visit www.SeniorCareAdvantageONE.com.

About Buffalo Medical Group
Founded in 1946, Buffalo Medical Group, P.C., is among the first and largest multi-specialty physician practice groups in New York State. With nearly 200 primary care, specialist, sub-specialist physicians and advanced practitioners – as well as a team of more than 800 nurses, technologists and other health care professionals – BMG records more than 850,000 outpatient visits annually at its main locations in Buffalo, Williamsville and Orchard Park as well as more than 10 satellite sites. For more information on BMG, visit www.buffalomedicalgroup.com.

 

2020-11-09T13:54:57-07:00October 23rd, 2020|

agilon health Partner Innovation & Platform Updates – August 2020 Newsletter

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Partner Innovation & Platform Updates

Partner Leadership

Team Member Bulletin

Innovation on the agilon health Platform

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2020-08-18T14:38:02-07:00August 17th, 2020|

agilon health Partner Innovation & Platform Updates – June 2020 Newsletter

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Partner Innovation & Platform Updates

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Innovation on the agilon health Platform

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2020-06-12T11:17:24-07:00June 8th, 2020|

We Are Here For You

DOCTORS SEND NATIONWIDE MESSAGE TO PATIENTS:
WE ARE HERE FOR YOU

Concerned that virus fears could lead to secondary health crisis, physicians launch a public service campaign urging patients to not neglect their health

Worried about the long-term health consequences caused by social distancing and isolation, physicians from all over the country are sounding the alarm to patients through a video released on social media:  “Don’t neglect your health. Make a promise to reach out.”   The “We are Here for You” video is being introduced as part of a national public service campaign, outlined on the website: www.WeAreHereForYou.us.  The campaign urges patients to resume critical healthcare services and allaying their fears of contracting the virus.

History has proven this can happen. During the SARS outbreak in 2002-2004, hospitalizations for patients with diabetes plummeted during the epidemic and then skyrocketed afterwards, according to a study by two Taiwan universities and Johns Hopkins Bloomberg School of Medicine in the U.S.  A recent ProPublica article indicates that a rise in at-home deaths may be due to patients with conditions such as heart attacks not being able to reach a hospital or refusing to go during the COVID-19 outbreak. (hyperlink) In addition, the New York City Fire Department is reporting an 800 percent increase of at-home cardiac deaths (not Coronavirus-related).

“We are trying to prevent a crisis within a crisis,” says Ben Kornitzer, M.D., Chief Medical Officer for agilon health. Dr. Kornitzer, whose expertise is caring for high risk, home-bound older adults, added, “Although older adults are at a heightened risk of contracting the disease, non-COVID19 medical care should not be overlooked – especially for seniors and patients with underlying conditions. That’s why agilon health and physician partners developed the ‘We are Here for You’ public service campaign to encourage patients to see their doctors now – before secondary symptoms arise or their conditions worsen.”

But with challenges, come opportunities.  “Pandemics always change the way society functions,” admits Dr. Kornitzer. “In the midst of a crisis, there are opportunities to learn how to do things better and to innovate. For example, telehealth has become a lifesaver for those who are desperately in need of care and reassurance during this difficult time.”

The website, which features resources for patients, includes new telehealth options and other ways of getting healthcare services during this challenging time. Some of those services include “telehealth on demand,” virtual annual wellness visits, drive-in telemedicine in parking lots, COVID-19 testing in parking lots and tents, and staggered clinic appointment hours for patients with symptoms of the virus and those who have other healthcare needs.

“Technology and science are helping us out now more than ever,” added Dr. Kornitzer. “As our partners connect with their patients via telehealth, they not only see their physical condition, but also their living situation – and can flag any important concerns or needs. Collectively, we all want patients to know we are here to help, and we won’t let them down.”

2020-05-15T14:05:43-07:00May 14th, 2020|

Steven Sell Named as New CEO

Steven Sell to Guide Accelerated Growth and Emphasize Collaboration with Physician Partners.

 

LONG BEACH, Calif.May 11, 2020 — agilon health, a company at the forefront of transforming health care delivery, today announced the appointment of Steven Sell, former Chief Executive and President of Health Net, to lead the company’s next growth phase and efforts to build deeper collaboration and partnerships with the local physicians at the foundation of its success.

Mr. Sell joins agilon June 1 after a successful 22-year career with Health Net and related companies.  At Health Net, a subsidiary of Centene Corp., he served as CEO and president from 2016 to 2019 and was responsible for the strategy, execution and financial performance of a $14 billion business with 3 million members.

Over the past three years, agilon has grown rapidly to establish a reputation for helping physicians nationwide to improve quality, the total cost of health care, and the patient experience.   The company’s purpose-built and practice-branded joint operating model has proven to be particularly effective in unlocking the Medicare Advantage opportunity embedded in physician practices.

agilon Chairman Ron Williams said while the company is proud of what it has built so far, this is the right time to bring in Mr. Sell, whose experience will help agilon strengthen its collaborative network.

“Steve wants to go fast – as do we,” Williams said. “This is a dynamic, thriving place, and we see a path to even deeper alignment with our current partners and more partnerships across the country.”

Mr. Sell will succeed Ron Kuerbitz, who oversaw the early success of agilon in developing physician partnerships and establishing the company’s distinctive reputation for physician empowerment. Mr. Kuerbitz is leaving to pursue other career endeavors.

During Mr. Kuerbitz’s tenure, agilon grew Medicare Advantage members on its platform from 22,000 to 150,000 and increased its relationships with payor partners and overall impact on regulatory reform.

“These impressive results are a testament to Ron’s leadership and the work of the company’s team and physician partners,” said Ravi Sachdev, agilon’s founder, and Clayton, Dubilier & Rice Partner.

Sell said he was impressed with agilon’s innovative spirit and ability to scale.

“I look forward to working with a remarkable team to dramatically grow agilon’s reach, build on its already substantial innovations and market contributions, and ultimately reinvigorate the delivery of care across the country,” Sell said.

Before joining Health Net, Mr. Sell was a consultant for Booz Allen Hamilton and held a variety of strategic and operational roles at The Prudential. He received his bachelor’s degree in economics and political science from Swarthmore College and his master’s degree in business administration from the Stanford Graduate School of Business.

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 seven 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 150,000 Medicare Advantage members on the agilon health platform with 1,200 primary-care physicians. Visit www.agilonhealth.com.

2020-06-03T11:04:13-07:00May 11th, 2020|
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