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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|

agilon health is pleased to welcome our new Chief Medical Officer, Benjamin Kornitzer, MD 

Meet Benjamin Kornitzer, MD: Chief Medical Officer for agilon health

agilon health is pleased to welcome our new Chief Medical Officer, Benjamin Kornitzer, MD!  Dr. Kornitzer joins agilon health with broad clinical and operational experience leading a diverse range of medical enterprises, including community-based practices, ACOs, IPAs, and integrated ambulatory networks.  For the past six years, Dr. Kornitzer has served as Chief Medical Officer of the Mount Sinai Health Network, which spans over 50 practice sites in New York, New Jersey, and Florida.  As CMO, Dr. Kornitzer oversaw one of the premier academic delivery networks in the country as the system developed robust population health tools, quality programs, care coordination resources, and invested in practice transformation.  As a faculty member of the Icahn School of Medicine, Dr. Kornitzer founded and directed Mount Sinai’s Physician Leadership Academy.

Dr. Kornitzer is board-certified in Internal Medicine and his clinical practice focuses on primary care for high risk, home-bound older adults.  Earlier in his career, Dr. Kornitzer had operational and strategic positions at leading community-based healthcare organizations focused on quality and value, including Balance ACO and House Calls Medical Group.  In addition to his clinical and operational roles, Dr. Kornitzer previously served as a strategic consultant with McKinsey & Company, where he worked with the U.S. and foreign governments, hospital systems, and pharmaceutical companies on some of their most critical strategic priorities.  Dr. Kornitzer earned his medical degree with Alpha Omega Alpha honors from Mount Sinai School of Medicine and completed his residency at Harvard Medical School/Massachusetts General Hospital.  He received his undergraduate degree in History from Brown University.  When he is not rolling up his sleeves working with physicians, practices, and patients, Dr. Kornitzer enjoys travel, skiing, ice hockey, cooking, spending time with family, and trying (mostly in vain) to keep up with repairs in his 1890s loft apartment.

Dr. Kornitzer is eager to work with our exceptional partners and team members to transform care delivery and provide the best experience and outcomes for our patients and return the sense of joy and fulfillment to primary care.

2020-02-19T02:14:34-07:00February 19th, 2020|

60 Strong Campaign, introduced in Columbus, Akron and Austin, as a public service initiative to promote wellness among baby boomers is another example of the strategy and execution around the high-quality care that agilon health delivers across its platform.

 

The pages of the calendar reveal a new year…and for many Baby Boomers, “take better care of myself” is likely on their 2019 resolution list. Exemplifying that is a dynamic group of 60 somethings in Columbus, Akron, and Austin – seniors who prove that a positive attitude helps them overcome the debilitating effects of chronic health conditions and live a longer, more productive life.

In an effort to “pay it forward,” these beacons of tenacity — ranging in age from 60 to 69 — are showing the world that it’s all about mindset and spreading the word to other seniors who have chronic health issues. The 60 Strong Ambassadors were chosen by a celebrity panel of judges to be highlighted in a 2019 calendar featuring activities and events that many seniors enjoy.

Ben Barlin, a 60 Strong Ambassador in Austin, was diagnosed with Stage III colon cancer. Ben could have easily become immobilized with self-pity. Instead, he decided to climb mountains. “To get my spirit back, I decided to summit Aconcagua, the highest peak in the Western Hemisphere,” he says.

The 60 Strong Ambassadors program is the brainchild of agilon health. The 60 Strong initiative was launched as a public service by agilon health with its partnership practices: Austin Regional Clinic and Premier Family Physicians, Austin; Central Ohio Primary Care Physicians, Columbus; and Pioneer Physicians Network, Akron; to transform the way they care for seniors. Sixty Strong Calendar Contests are slated for several other markets, including Pittsburg and Dayton, in 2019.

Kevin Spencer, M.D., Medical Director for the Austin-based partnership with agilon health and Chairman of the Board of Premier Family Physicians, says, “Like Ben, all of our winners in the 60 Strong Campaign are very inspiring. Although many of them struggle with debilitating health issues, they all make fitness a priority and remain positive about the future. Some have founded their own charities, and all are donating time to non-profits and their communities.”

The Ambassadors speak at Medicare expos and senior events, and while their life challenges differ, they all have a common message about the importance of preventing chronic disease and maintaining good health, which is a growing concern in this age group.

The Centers for Disease Control (CDC) reports three in four US adults aged 65 and older have a chronic disease, such as cancer, heart disease or diabetes. Those numbers are expected to rise significantly with a rapidly growing population and increased life expectancy in the U.S. The Population Reference Bureau estimates the number of Americans 65 and older will more than double from 46 million today to 98 million by 2060.

Angela Bosela, an Akron 60 Strong Ambassador who had 70% of her stomach removed in 2007 and endured chemotherapy and radiation treatments, was inspired to become a competitive runner.

“After cheering for my daughter at a race, I was motivated to start running,” Angela says. “I’ve now completed 200 races, including a marathon and 15 half marathons, and I often place in my age group.”

Angela is also a volunteer counselor for stomach cancer survivors, and she and her husband Paul founded the Ohio Chapter of Debbie’s Dream Foundation, an organization that provides support to stomach cancer patients and their families.

Some of the 60 Strong Ambassadors are grief counselors; they also serve as spokespersons about Medicare coverage and other healthcare decisions and emphasize the importance of annual physicals, regular screenings, and exercise.

The last point is critical. According to the CDC, one-third of older adults do not get regular physical activity.

In gratitude for their newfound lease on life, the 60 Strong Ambassadors are literally paying it forward,” says Bill Wulf, M.D., CEO of Central Ohio Primary Care Physicians.  “The 60s are a difficult period — it’s often the first time people experience real health struggles. The Ambassadors have already experienced adversity, so they provide encouragement to others and give them hope.”

For the list of the ambassadors and to learn more about their inspirational stories, click here for Akron Austin, and Columbus.

2019-02-05T18:54:48-07:00January 18th, 2019|

Ron Kuerbitz, agilon health CEO, delivers his New Year’s address to employees.

 

Go confidently in the direction of your dreams…. If one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours…

Henry David Thoreau, Walden

Now this is not the end.  It is not even the beginning of the end. But it is, perhaps, the end of the  beginning.”

Winston Churchill, The Lord Mayor’s Luncheon, November 10, 1942

 

 

Happy New Year!  As we look back at 2018 and as 2019 begins to unfold, it seems like an opportune time to reflect on what we’ve accomplished, the journey we have set out on to transform the delivery of care and the plans we have for an exciting, bright future.

Last year was a year of growth and transition, one in which we completed the initial work necessary to consolidate our platform programs in Hawaii and California and established long-term partnerships with leading physician groups across the country.

We successfully launched our COPC Senior Care Advantage partnership in collaboration with Central Ohio Primary Care and finished the year by helping COPC serve more than 25,000 Medicare Advantage patients in the greater Columbus area with a patient net promoter score of 55.  In 2018, COPC physicians performed wellness visits for more than 95% or their patients, setting the stage for substantial innovation and improvement in care with a singular focus on individual patient needs.

Through the intense collaborative efforts of both local and enterprise-based teams, we transformed the economic sustainability of our MDX Hawaii network, enabled double-digit annual growth, and created the leading delivery model in Hawaii, serving more than 33,000 members.

Two market-leading physician practices in Austin, Texas – Austin Regional Clinic and Premier Physicians – joined the agilon health platform and together we established the Connected Senior Care Advantage program, which will serve more than 17,000 patients in its inaugural year.  And finally, we welcomed the physicians and staff of Pioneer Family Physicians, who are developing and expanding the Paradigm Senior Care Advantage partnership in Akron, Ohio with us.  During our preparations to go live on January 1, 2019, Pioneer’s physicians performed annual wellness visits for more than 90%, or over 7,800, of their patients.

I am especially pleased that all the Senior Care Advantage partnerships on our platform are well-positioned to deliver 4-Star, efficient care in 2019.  We celebrated an industry-leading 75 Net Promoter Score (“NPS”) amongst our physician partners in Columbus, Austin and Akron, and an NPS improvement of 70% in Hawaii, indicating that our focus on physician engagement and streamlining administrative processes and procedures is on the right track.

I am tremendously proud of the team and infrastructure we’ve built and the results we’ve delivered in two short years.  But perhaps what I’m most proud of is the way the entire agilon health organization responded when ‘the going got tough’.  As many of you know, during 2018 a large part of our team was consumed with developing and executing remediation plans to address compliance issues that we identified in our legacy, California-based PPMC operations.  Following our self-disclosure and eight months of well-executed remediation, we passed audits from all our health plan partners and DMHC.  In short, we identified potential wrongdoing, we disclosed it, we investigated further to ensure the wellbeing of patients under our care was not impacted, and we swiftly corrected the issues.

While I’m confident the issues resident within our legacy operations are behind us, we know that with each new year comes new challenges and goals.  For agilon health, 2019 will be a year focused on scalability and growth.  We look forward to announcing new partnerships with leading health systems and physician organizations that are committed to taking the leap to integrated payment and delivery.  I expect we will at least double our partnerships, resulting in expansion into at least 15 markets over the next two years.

We look forward to seeing the evolving benefits of innovative physician leaders collaborating across markets as they work independently and collectively to transform payment and care delivery.  We look forward to expanding our health plan arrangements to include new geographies, new products, and deeper relationships.  Most importantly, we look forward to being closer to fulfilling our mission of providing a platform from which physicians can lead the transformation of both their local markets and the nation to value-based care as they strive to recapture the joy of practicing medicine.

There is no roadmap for what we’re doing.  No one has been successful previously in building a national platform… partner… integrated payment and delivery…  So, like Churchill, we cannot be sure precisely where we are in that journey and like Thoreau, we cannot precisely determine next steps.  But like Churchill, we can see that we are emerging from the initial phase of our journey and, like Thoreau, we can be confident that great success lies in following our dreams – the kind of achievement that is unexpected by those who do what is expected and anticipated.

I’d like to conclude by sharing how proud I am of the courage, innovation and determination you have each displayed in 2018.  The confidence, hard work, expertise, collaboration and integrity of each agilon health team member and every partner on our platform has allowed us to confidently pursue a vision of a healthcare system across the nation that delivers high-quality care at sustainable cost with high levels of satisfaction – even joy – to patients, physicians and all our partners in care. Thank you for your unwavering dedication and support.  Here’s to a momentous 2019.

 

2019-01-16T00:47:30-07:00January 15th, 2019|

Ron Kuerbitz, CEO, Reaffirms agilon health’s Commitment to Compliance and Integrity as a Leader in Care Delivery.

I wrote to you this past summer as we developed and executed remediation plans to address compliance issues that we identified in our historical PPMC operations.  From time to time we get questions regarding our progress on the remediation and about the compliance issues from our legacy California operations.  As the year comes to a close, I would like to reaffirm that the facts we disclosed were accurate and no new information has come to our attention; our view has not changed.

As part of our work to centralize and standardize our claims payment operations into a single, high-functioning department, we identified practices in the claims audit processes of our legacy California operations that required remediation.  We immediately, and without hesitation, disclosed these claims issues to the California Department of Managed Health Care (DMHC) and our plan partners in February 2018 and engaged outside experts to conduct a thorough investigation.  This voluntary self-disclosure reflects our singular commitment to compliance and our integrity as leaders in care delivery.

The investigation confirmed improprieties in the claims audit process but did not identify systemic errors or processes that would have impacted patient care. Following a complete remediation of those processes, we have since passed audits from all our health plan partners as well as DMHC. Our remediation plan focused on three key initiatives:

  1. The appointment of highly experienced new leadership to oversee the claims, customer service and utilization management functions;
  2. The implementation of new claims processing and operating system and enhanced management processes and procedures;
  3. The dismissal of all employees who took part in the improper activities.

In short, we identified potential wrongdoing, we disclosed it, we investigated further to ensure the wellbeing of patients under our care was not impacted, and we swiftly corrected the issues.

We continue to work closely with our health plan partners to improve the care for patients in California and across the nation and we are excited about the innovative steps we are taking to bring new levels of quality and efficiency to our physician partners, health plan collaborators, and patients in 2019.  I look forward to being able to share more details on those plans as the new year unfolds.

 

2018-12-20T17:31:55-07:00December 18th, 2018|

Our Culture of High Integrity and Compliance

As part of our ongoing work to centralize and standardize our claims payment operations into a single, high-functioning department, we identified practices in the claims audit processes of our legacy California operations that require remediation.  We immediately, and without hesitation, disclosed these claims issues to the California Department of Managed Health Care (DMHC) and our plan partners in February 2018 and engaged outside experts to conduct a thorough investigation.  This voluntary self-disclosure reflects our singular commitment to compliance and our integrity as leaders in care delivery.

Since then, we have met in person with DMHC, completed our claims process investigation, taken steps to fully remediate those processes and have supported numerous health plan audits.  We remain committed to our physician partners and members in California and continue to make significant progress in the implementation of our new MSO, and quality systems in the California market. These initiatives include:

  • The appointment of highly experienced leadership at the MSO;
  • The implementation of enhanced controls and management oversight of our legacy system;
  • The adoption of an accelerated timeline for the movement to CORE, our new operating system; and
  • Visits to over 100 primary care providers in May, which featured the delivery of comprehensive quality program toolkits that were well received across the board.

As of today, some audits are on-going and we are actively engaged in constructive and transparent remediation efforts with our contracted health plan partners.  Just as we have promised to do with the DMHC, we will keep you fully updated on our progress toward full remediation of all audit issues.

We are particularly grateful for the opportunity to continue to collaborate in California with Aetna, Anthem Blue Cross, Blue Shield, Brand New Day, Care1st, Health Net, Humana, and Molina.  We value these relationships and look forward to many years of successful collaboration with these plans in service to their members.  As some of you may know, however, IEHP has decided to terminate our contract effective August 31, 2018.   We regret that IEHP has felt it necessary to take this action, but our first concern is that we minimize adverse impacts on the members.  We are committed to work collaboratively with IEHP on its block transfer process and to ensure continuity of care.

I would like to recognize and thank the California team for their tireless commitment to our physician partners and members.  We know many of our employees live in the Riverside and San Bernardino communities we serve and are honored to be serving their neighbors, friends, and families. We all hold that trust and responsibility in high regard.

And while strength in California remains critical and is a testament to our history, the future of agilon health is also defined by our growing network of providers and members in Hawaii, Ohio, and Texas as well as new markets yet to come.  Today, we collaborate with approximately 1,000 primary care physicians outside of California who are partnering with us to care for over 65,000 Medicare Advantage members.  We continue to build our organization across the country to fulfill our promise of higher quality, more connected care for our partners and members across the country.

 

 

 

 

2018-12-27T19:02:20-07:00June 6th, 2018|

Protecting a Reputation of High Moral and Ethical Standards

“A good reputation is hard-won and easily lost. But the lost reputation has invariably been given away by the actions of the holder, rather than been taken away by somebody else.”
– C. Beveridge

In a very short period of time, agilon health has established and enjoys a very positive reputation across our industry.  This reputation rests on all of our shoulders and is the direct result of the good work we all do day in and day out.  In these holiday months when we are reminded of all of our blessings and show our appreciation to those who mean so much to us, I want you to know that I feel it is a privilege to work with you on such an important endeavor and I thank you for your commitment to agilon health.  Your hard work and relentless pursuit of enabling our physicians to provide high quality and efficient health care to our members have already brought us very positive recognition at a national level.  Our reputation influences so many aspects of our company – the way our physician customers and partners value our services; whether or not health plans choose to contract with us and entrust their members to us; how regulators perceive us; and whether employees find agilon health a fulfilling place to work.  A strong reputation will fuel growth and future success.  We should not take it for granted.  Therefore, it is important for all of us to protect our reputation through a strong culture of integrity and ethical conduct.

As part of our evolution as a high performing organization which brings people, solutions, capital, and technology to enable primary care physicians to achieve long-term success, we have recently adopted a Code of Conduct that applies to all of us.  All employees of agilon health are responsible for knowing the Code of Conduct and for abiding by high legal, ethical and moral standards.  Every employee of agilon health is also required to be familiar with and comply with all federal and state laws, rules, and regulations that govern their role within the organization. If you are unfamiliar with what those rules are, it is your obligation to ask.  Not knowing the rules, or turning a blind-eye into activities you are not comfortable with is not acceptable and violates our Code of Conduct.

Whether you work in California, Hawaii or Ohio and no matter what your contributions and responsibilities are within the organization, we are all accountable for upholding these principles and behaviors in accordance with the highest of ethical and legal standards. Our Code of Conduct obligates us to avoid any conduct that even raises the appearance of impropriety and to hold ourselves to even higher ethical standards than the legal rules require.  It is also important that we recognize that breaches of the Code of Conduct will be taken seriously.

The Code of Conduct is now available on the agilon health website by clicking here.  In addition, all managers will receive a copy of the Code of Conduct and are expected to review it with their teams in December.  Given the importance of the Code of Conduct to all of us and the way that we do business, I trust you will read it with due care and attention. If you have any questions, are unsure about a particular policy or compliance issue, or believe, or even are just uncertain whether the Code of Conduct has been broken by anyone in the organization we urge you to speak to your supervisor or call the Compliance Hotline at 833-668-8638.  Asking questions and raising issues helps make us all smarter and more effective.  With your help, I am confident that our reputation will be upheld long into the future.

 

2018-12-27T19:02:37-07:00December 15th, 2017|

Golden Valley Health Centers Launches Sequoia Health, a New Populations Health Management Joint Venture, with agilon health.

GOLDEN VALLEY HEALTH CENTERS LAUNCHES SEQUOIA HEALTH, A NEW POPULATION HEALTH JOINT VENTURE, TO EXPAND AND IMPROVE CARE TO CENTRAL VALLEY UNDERSERVED PATIENTS

Transformative Joint Venture with agilon health enables Golden Valley Health Centers To Focus on Prevention and Highly Coordinated Clinical Care and Access New Payment Model

 

Merced, CA (November 1, 2017) – Golden Valley Health Centers (GVHC), one of central California’s largest non-profit network of community health centers that provide care for thousands of underserved patients, has partnered with agilon health of Long Beach, California, to launch Sequoia Health, a new entity that will allow GVHC and other high-quality providers to offer a provider-led, value-based, population health program that improves access and quality care for the patients they serve.

Serving more than 150,000 patients through its network of 29 clinics, GVHC is one of the largest medical providers to Medi-Cal patients in the Central Valley. GVHC will continue to operate as it always has and the brand will not change. Sequoia Health will enable GVHC and other providers to participate in a population health program by providing contracting, data collection and management, care coordination, clinical programs and administrative services.

The nation’s health care system continues to transition from the fee-for-service model that rewards the volume of services a provider delivers, to a more value-based approach. Organizations like Sequoia Health, which offer risk-bearing population health programs that provide efficient coordinated clinical care and expanded access to high-quality care for vulnerable populations, allow providers like GVHC to stay ahead of the curve.

“Sequoia Health is a unique partnership with agilon health that will create a new footprint in how we expand and serve our patients,” said Tony Weber, Chief Executive Officer of GVHC, which is headquartered in Merced. “This new model puts the patient at the center of our clinical care model, with our dedicated care teams working side-by-side to ensure that each patient gets the appropriate care at the right place at the right time. This is an exciting new model for GVHC because it allows us to direct locally the dollars that are spent on the right care to meet the needs of our community. Moreover, it will allow us to recruit additional high performing providers and add more resources to improve access to high-quality care. “

GVHC’s partner in Sequoia Health is agilon health, a Long Beach, California-based company that serves nearly 500,000 Medi-Cal members, is investing capital and bringing resources in technology-enabled clinical, operational and administrative expertise that help independent organizations like GHVC to transition into value-based health care. “In Golden Valley Health Centers, we found a like-minded partner which has a rich history of providing great medical, behavioral, and dental care to the underserved,” said Manoj Mathew, MD, agilon health’s Market President for California. “GVHC is an ideal partner to embrace a transformative payment model which puts overall control for patient care back into the hands of physicians and care teams. Patients will benefit greatly with a focus on prevention and highly coordinated clinical care.”

The concept of highly coordinated care is effectuated through efficient processes, systems, and data that enables intense collaboration between doctors, nurses, assistants and other allied health care team members such as social services and specialists among others. In a population health model, preventive care is the flagship focus.

“This new partnership will allow Golden Valley Health Centers to expand existing efforts to provide high-quality cost-effective care to our patients. Through increased focus on clinical metrics such as childhood immunizations, age-appropriate well-child visits, preventative care screenings for breast and colon cancer as well as improved focus on the care of chronic diseases such as diabetes and hypertension, Sequoia Health will improve not just the care of our individual patients but of the entire community” said Ellen Piernot MD, MBA, Chief Medical Officer for Golden Valley Health Centers.

“Through GVHC’s participation in Sequoia Health, our team is responsible both financially and clinically for the health of each patient. Sequoia Health will partner with us to develop local programs to ensure higher quality health care, including programs that prevent people from needing emergency room care and help them remain independent in their homes. We value the trust our partners have shown in our ability to improve the health status of our communities,” added Weber.

In its launch, Sequoia Health has contracted with Health Net, a large California health plan that provides and administers health benefits to many Medi-Cal enrollees, as its first partner in this new model.

For more information, click www.SequoiaHealthIPA.com

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2019-01-04T21:12:05-07:00November 1st, 2017|

Central Ohio Primary Care Physicians and Area Medicare Health Plans Partner Through COPC Senior Care Advantage To Launch New Population Health Management Model to Revolutionize Care for Medicare Members in Central Ohio

COPC Senior Care Advantage Will Focus on Prevention and Highly Coordinated Care delivered through a Team of Experts to Improve the Health and Wellness of Medicare Advantage Patients in a Value-Based, Population Health Model.

To revolutionize the care it provides its Medicare Advantage patients, Columbus-based Central Ohio Primary Care (COPC), the largest physician-owned independent primary care medical group in Ohio and the largest in the U.S., has entered into an agreement with local and national Medicare Advantage plans through COPC Senior Care Advantage, a new population health management program designed to improve the quality, value, efficiency, patient experience and outcomes of Medicare Advantage patients.

COPC Senior Care Advantage will commence transforming care for Medicare Advantage patients beginning in January of 2018, thanks to new population-health based contracts with all Aetna Medicare Plans (HMO/PPO), Anthem Mediblue Dual Advantage, Anthem Mediblue Access, Anthem Mediblue Access Enhanced, Anthem Mediblue Access Core, Anthem Mediblue Access Basic, Humana Gold Plus HMOs and HumanaChoice PPOs, MediGold Classic Preferred (HMO), MediGold Essential Care (HMO), MediGold Flexible Choice (PPO) and MediGold Medical Only (HMO). COPC is also contracted with other Medicare Advantage plans through legacy agreements.

“As a physician-led organization, our goal is to put the patient’s needs first and foremost, and this program by COPC Senior Care Advantage will enhance the great care we have historically provided to our Medicare Advantage patients,” said William Wulf, M.D., chief executive officer of Central Ohio Primary Care Physicians, which has more than 350 providers and 62 practice locations throughout central Ohio. “This new model will be coordinated care on steroids,” said Dr. Wulf, a long-time advocate for value-based care. “COPC Senior Care Advantage is an innovative population health model designed to provide higher quality, more efficient care for local Medicare Advantage patients,” said Ben Shaker, President of COPC Senior Care Advantage. “Through this collaboration with COPC, we are taking the value-based model to a new level of health and wellness by focusing on prevention and highly coordinated clinical care.”

By partnering with like-minded Medicare health plans, COPC Senior Care Advantage will be accountable for improving the health care of COPC’s Medicare Advantage patients. Under this model, the physicians at COPC will coordinate all of the care for enrolled members, including primary care, specialists, major local health systems and hospitals, laboratories and all of the ancillary services necessary to improve the health status of such members. They will also engage in advanced data analytics to support clinical decisions, ensuring that the appropriate care is delivered at the right time and place.

“We believe that more efficient care is possible if physicians assume both clinical and financial responsibility for patient care. By having robust data and increased resources at their fingertips, COPC physicians will be better able to deploy highly integrated, prevention-oriented care. Better outcomes are possible when innovative clinical programs are supported by actionable and timely data,” said Ben Shaker.

The COPC Senior Care Advantage program is designed to allow COPC physicians to spend more time with their patients. “Taking care of senior patients is more complicated than ever before given the prevalence of chronic illness among this population. Through this new arrangement, COPC Senior Care Advantage will be supporting COPC physicians with case managers, social workers, nurses and quality assurance staff,” said Dr. Wulf. “The purpose is to allow our doctors to spend more time with patients, providing support, counseling and prevention services to help patients remain independent and improve their health.”

Across the country, health care officials are seeking ways to change the health care system from one that rewards the volume of services doctors provide to one that rewards high quality and value. The goal is to offer better quality care and save money by providing the right level of care at the right time with a focus on prevention. If patients are healthier, they are less likely to need expensive hospitalization or emergency care.

“This is an innovative approach to medical care for seniors, one that would benefit our members for years to come,” said Michael Vincent Smith, MD, FACC, FACS, FCCP, Regional Vice-President, Medical Director, Central Region Medicare, Anthem, Inc., one of the Medicare Advantage plans partnering with COPC Senior Care Advantage. “This new partnership has the potential to improve health outcomes and keep costs down for both members and health plans, particularly for those members who suffer from such prevalent chronic illnesses such as congestive heart failure, diabetes, COPD and hypertension. We are very excited to be a lead partner in this new model of care for our Medicare Advantage members.”

After more than a year of planning and staff additions, COPC Senior Care Advantage brings together multiple health care providers and health plans under a program dedicated to transform the health and wellbeing of Medicare Advantage members in the greater central Ohio area. The COPC Senior Care Advantage program through COPC will be available beginning January 1, 2018 for all Medicare Advantage members of participating health plans. For more information about COPC Senior Care Advantage, please visit www.COPCseniorcareadvantage.com

2018-12-27T19:05:25-07:00October 23rd, 2017|

William Wulf, MD, agilon health board member and CEO of Central Ohio Primary Care Physicians, is one of esteemed speakers featured in an upcoming CAPG webinar on MACRA

 

agilon health board member and CEO of Central Ohio Primary Care Physicians (COPC), Willam Wulf, MD is one of the esteemed speakers featured in an upcoming CAPG webinar on MACRA (Medicare Access and CHIP Reauthorization Act).  COPC, the largest independent and physician-owned primary care practice in the country and partner with agilon health in a new healthcare delivery model in Columbus, Ohio called COPC Senior Care Advantage, is navigating the complexity of MACRA by not only participating in CPC Plus, which is recognized by CMS as an Advanced Alternative Payment Model which qualifies COPC for the preferential APM track within MACRA, but they are also focusing on growing the number of their patients in Medicare Advantage plans, thereby reducing their exposure to changes in traditional Medicare reimbursement. COPC Senior Care Advantage provides COPC patients a compelling alternative to traditional Medicare coverage and is made possible by the innovative payer agreements agilon health and COPC executed with the leading insurance plans in the market.

COPC Senior Care Advantage is a new program for patients covered by the Medicare Advantage plans from Aetna, Anthem, Humana and MediGold in Central Ohio, which expands the cooperation and coordination between COPC and these insurance companies*. COPC Senior Care Advantage is not a new Medicare Advantage plan.  Rather it is a new program that allows patients the flexibility to choose a health plan from four participating insurance companies and still have access to the same innovative care program COPC and agilon health have designed to enhance access to wellness and health education services, as well as care coordination resources.  It provides patients the best of both worlds – flexibility in choosing their benefits from any one of the health plan partners and at the same time consistent access to this new program at COPC.  COPC Senior Care Advantage will begin on January 1, 2018. 

2018-12-27T19:04:19-07:00October 5th, 2017|
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