Press Release

/Press Release

agilon health Signs Value-Based Agreements with Humana.

Humana and agilon health Expand Relationship, Announce Value-Based Agreements with Physician Groups

Working Together to Help Independent Practices Transition from Fee-for-Service

 

LOUISVILLE, Ky. & LONG BEACH, Calif.  November 20, 2019 –Humana Inc. (NYSE: HUM), one of the nation’s leading health and well-being companies, announced today that it has signed value-based care agreements with agilon health, which helps physicians and medical groups manage the transition from fee-for-service reimbursement, on behalf of three independent physician practices located in Ohio and Texas.

Effective January 1, 2020, the contracts are designed to improve health outcomes and the patient experience for Humana Medicare Advantage Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) members seeking care from physicians and other clinicians at Physicians Group of Southeastern Ohio (PGSEO) in southeast Ohio, PriMed Physicians in southwest Ohio, and Capital Medical Clinic in central Texas. Clinicians participating in Humana’s Medicare Advantage network will be able to utilize tools and resources from both agilon health and Humana in delivering value-based care.

These agreements supplement existing value-based contracts between Humana and agilon health for MDX Hawai‘i in Hawaii, Central Ohio Primary Care (COPC) and Pioneer Physicians Network in Ohio, and Austin Regional Clinic (ARC) and Premier Family Physicians in Texas, for a total collaboration involving more than 1,800 independent primary care clinicians.

“We’re proud to deepen our work with Humana in support of independent physician groups as they care for their patients,” said Ron Kuerbitz, CEO of agilon health. “We’re pleased that through our expanding network of physician partners, and in collaboration with Humana, we can help additional communities become healthier, and enable a growing number of primary care physicians to spend more time with patients toward improving their care.”

Agilon health partners with primary care physician groups, and provides the tools – the data, technology, capital, and workflow – so doctors are free to be the doctors they trained to be and ready to take on the responsibility for quality care of their patients.

“Through our work with agilon health, Humana is pleased to expand our ability to support independent physicians interested in moving to a value-based care model,” said Oraida Roman, Vice President, Value Based Strategies at Humana. “We look forward to sharing data and analytics with these physicians, and improving health outcomes and the patient experience for our Medicare Advantage members in Ohio and Texas.”

The value-based agreements with agilon health are in keeping with Humana’s longstanding commitment to value-based care, which emphasizes:

  • More personal time with health professionals and personalized care that is tailored to each person’s unique health situation;
  • Access to proactive health screenings and programs that are focused on preventing illness;
  • Improved care for people living with chronic conditions with a focus on avoiding health complications;
  • Leveraging technologies, such as data analytics, that connect physicians and help them work as a team to coordinate care around the patient; and
  • Reimbursement to physicians linked to the health outcomes of their patients rather than based solely on the quantity of services they provide (fee-for-service).

Humana has an extensive and growing value-based care presence. As of Sept. 30, 2019, Humana has more than 2.3 million individual Medicare Advantage members and approximately 115,000 commercial members who are cared for by more than 60,000 primary care physicians in more than 1,000 value-based relationships across 43 states and Puerto Rico. Humana’s total Medicare Advantage membership is more than four million members, which includes members affiliated with providers in value-based and standard Medicare Advantage settings.

Terms of the agreements were not disclosed.

 

About agilon health

agilon health of Long Beach, California, a company founded in 2016 by world-class health care leaders, is helping U.S. physicians manage the leap from fee for service to global risk-based health care.  Recognizing the increasing pressure on physicians caused by the existing healthcare system, agilon health has created a complete operating platform for managing global risk-based health care that brings people, processes and proprietary technology together in partnership with physicians to take responsibility for total healthcare spend.  The company has now expanded its operations to leading positions in nine U.S. markets.   For more information visit www.agilonhealth.com.

 

About Humana

Humana Inc. is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.

To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools – such as in-home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a simplified experience that makes health care easier to navigate and more effective.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:

  • Annual reports to stockholders
  • Securities and Exchange Commission filings
  • Most recent investor conference presentations
  • Quarterly earnings news releases and conference calls
  • Calendar of events
  • Corporate Governance information

Additional Information

Humana is a Medicare Advantage HMO and PPO organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. Other providers are available in our network. The provider may contract with other Plans.

 

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2019-11-20T18:43:03+00:00 November 20th, 2019|

agilon health Partners with Market-Leading Independent Physician Groups in Austin, TX, and Akron, OH, Expanding to Leading Positions in Six U.S. Markets

Unique value-based physician partnership model empowers physicians to remain independent by embracing the agilon health integrated operating platform to support the successful transition to a global risk-based business model

LONG BEACH, Calif. –  Oct. 29, 2018 – agilon health, which partners with primary care physicians to unlock the value inherent in the leap from fee-for-service to a global-risk based business model,  today announced that it has entered into a joint venture with leading independent physician practices Austin Regional Clinic (ARC) and Premier Physicians in Austin, Texas, and with Pioneer Physicians Network in Akron, Ohio.  These recent partnerships expand upon agilon health’s efforts to both improve and accelerate the growth of risk-based models of care in key geographies across the country through the introduction of a complete operating platform for integrated payment and delivery.

With today’s announcement, agilon health has successfully entered into seven partnerships with leading physician groups and networks, empowering primary care providers in six markets to influence the continued transformation of their local care delivery systems around the principles of cost and quality.  Across these six markets, agilon health has signed 17 global risk contracts with multiple payors, including Humana and WellCare, that will serve the Medicare Advantage population in 2019.

In 2017, agilon health and Columbus, Ohio based Central Ohio Primary Care (COPC), the largest independent primary care medical group in the U.S. with 375 providers at 67 locations and over 25,000 Medicare Advantage members under its care, formed the first partnership of this kind to support the transition to a global risk-based business model. Through the partnership, COPC has seen more than a 10 percent increase in patients participating in their new Medicare Advantage global risk model, and delivered improvements in patient and physician experience, and clinical outcomes.

“We have been very impressed by the opportunity for transformation across all elements of our business that our partnership with agilon health has created,” said William Wulf, MD, CEO, Central Ohio Primary Care Physicians. “Our partnership-centric operating model focused on integrating payment and delivery in our market has led to significant improvements across our practice – strong physician engagement, the implementation of network management strategies such as centralized referral management, new sites of care such as a high-risk clinic, and robust patient engagement measured by annual wellness visits for over 95% of our patients – to name a few.  Our physicians can dedicate themselves to the care of their patients with the knowledge that our practice’s new Medicare Advantage program, and consequently the practice itself, will grow and thrive through the partnership with agilon health.”

“I am exceptionally proud of the work done by our team over the past two years to establish truly collaborative partnerships with physicians that are fundamentally changing the way health care is provided to seniors and vulnerable populations across the country,” said Ron Kuerbitz, CEO of agilon health. “On a daily basis, physicians find themselves on the front lines of the transition from fee-for-service to high-quality value-based care, and often without a partner, business model, or the capabilities to capture the opportunity being created by the transition to value-based care. At agilon health, we have created a business model and an operating platform for physicians, to successfully drive change, allowing our partners to provide the right care for each patient at the right time and allowing physicians to rediscover the joy of practicing medicine. We see tremendous opportunity to continue growing, and we expect to provide our technology-enabled risk services to over 15 markets across the U.S. in the next two years.”

 

About Austin Regional Clinic

Austin Regional Clinic is a multispecialty medical group committed to providing comprehensive health care services throughout the greater Austin area. Founded by three physicians in 1980, ARC now provides health care to over 471,000 area residents in 24 locations in ten cities, including both primary and specialty care. It is unique to the Austin area because of the widespread locations, convenient services, and quality assurance programs. ARC patients enjoy access to such conveniences as same-day appointments, 24/7 online or phone scheduling, after hours clinics, nursing services through the night, and access to their providers through the MyChart patient portal. Most ARC locations also offer on-site radiology and lab services, and some clinics offer specialty programs such as a travel clinic and weight loss programs. For more information, visit www.austinregionalclinic.com.

 About Pioneer Physicians Network

Pioneer Physicians Network has 50 board-certified primary care providers practicing at 16 locations with specialties of Family Practice, Podiatry, Pediatrics, and Internal Medicine. We are proud to be one of the largest primary care independent physician groups in Northeast Ohio and recognized and accredited by the National Committee on Quality Assurance as a Level 3 Patient-Centered Medical Home.  As a physician-owned and physician-led organization, our providers’ promise is to serve our community with cutting-edge medical initiatives and superior medical staff and services.

 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 375 providers and 67 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.

 About agilon health

agilon health of Long Beach, California, a company founded in 2016 by world-class health care leaders, is helping U.S. physicians manage the leap from fee for service to global risk-based health care.  Recognizing the increasing pressure on physicians caused by the existing healthcare system, agilon health has created a complete operating platform for managing global risk-based health care that brings people, process and proprietary technology together in partnership with physicians to take responsibility for total healthcare spend.  The company has now expanded its operations to leading positions in six U.S. markets.   For more information visit www.agilonhealth.com.

2018-12-27T19:00:47+00:00 November 1st, 2018|

WellCare Partners with agilon health to Form Value-Based Care Agreement

TAMPA, Fla.Oct. 8, 2018 /PRNewswire/ — WellCare Health Plans, Inc. (NYSE: WCG) announced today it has expanded its network of providers by signing a new value-based care agreement with agilon health, a leading national organization which brings a complete operating platform for global risk to primary care physicians, to help improve access to care and drive greater health outcomes for its members in Texas.

Value-based programs reward healthcare providers with incentive payments based on the quality of care provided rather than the services delivered. The aim is to provide better care for individuals, improve population health management and reduce healthcare costs.

“We’re thrilled to partner with agilon health to help provide our members with access to high-quality, coordinated health care,” said Sue Podbielski, WellCare’s vice president, network performance. “Working together, we can collectively deliver improved health outcomes and an enhanced experience for our members. Our goal is to move to more value-based care agreements that incentivize positive health outcomes.”

“We’re excited to partner with WellCare,” said Ron Kuerbitz, agilon health’s chief executive officer. “We are committed to providing quality, value-based, preventive and personalized care and look forward to bringing our proven model to WellCare members.”

Across the country, agilon health manages care for more than 300,000 patients through a network of more than 14,000 physicians across four states. For more information about agilon health, visit www.agilonhealth.com.

About WellCare Health Plans, Inc. 
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services to families, children, seniors, and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 1, 2018. For more information about WellCare, please visit the company’s website at www.wellcare.com.

2018-12-27T19:01:05+00:00 October 9th, 2018|

agilon health Expands Into Five Markets Through Innovative New Joint Venture Partnerships. Company Empowers Physician Partners to Win in Value-Based Care Through a Complete Integrated Operating Platform.

 

LONG BEACH, CA – agilon health of Long Beach, California, a year-old company founded by world-class health care leaders, is helping U.S. physicians manage the leap from fee for service to value-based health care.  Recognizing the increasing pressure on physicians caused by the existing healthcare system, agilon health has created a complete operating platform for value-based healthcare that brings people, process, and proprietary technology together in partnership with physicians to take responsibility for total healthcare spend.  The company has now expanded its operations to leading positions in five U.S. markets.

agilon health was founded in 2016 by Clayton Dubilier & Rice, one of the nation’s leading private equity firms.  The agilon health team includes Chairman Ronald A. Williams, formerly Chairman & Chief Executive Officer of Aetna, and CEO Ron Kuerbitz, formerly Chief Executive Officer of Fresenius Medical Care North America.  

Building upon a model of establishing anchor positions in key markets, agilon health has entered Central Ohio through a joint venture with Central Ohio Primary Care Physicians (“COPC”), the nation’s largest independent, physician-owned primary care medical group.  This pioneering model, called COPC Senior Care Advantage, supports comprehensive care in Central Ohio with a full risk model for over 20,000 Medicare Advantage members across multiple payers. agilon health’s proprietary technology-enabled clinical and administrative operating system will support the partnership’s ability to accept and manage this comprehensive care full risk model for Medicare Advantage patients in the Central Ohio geography.

In the Central Valley of California, agilon health formed Sequoia Health, a new risk-bearing partnership with Golden Valley Health Centers, one of central California’s largest non-profit networks of community clinics that provides care to thousands of underserved patients through California’s Medicaid program.  This new venture provides Golden Valley Health Centers the opportunity to direct not only the care their providers personally perform, but also to assume responsibility for coordinating all care and quality initiatives for their patients.  It positions Golden Valley Health Centers to expand access to primary and specialty care services in additional underserved communities.

These recent partnerships expand upon agilon health’s efforts to both improve and accelerate the growth of risk-based models of care in geographies across the country through the introduction of a complete operating platform for risk.  Beyond the Central Valley of California, agilon health has established positions in southern California and Fresno with significant investments in partnerships with leading local IPAs.  In greater Southern California these partnerships serve more than 390,000 Medi-Cal, including through the Vantage Medical Group.  In Fresno, agilon health is implementing its operating model through First Choice Medical Group, which serves over 70,000 Medi-Cal members and 7,000 MA members.  In Hawaii, agilon health, operating as MDX Hawaii, operates a full risk model to provide care to more than 28,000 MA members.  This full risk model is the first of its kind in Hawaii and enhances the value that MDX Hawaii currently provides to physicians, patients, and health plan partners.    

“Our mission is to be a great partner to physicians, whose pivotal role in improving care quality and efficiency puts them on the front lines of the transition from fee-for-service to high quality, sustainable value-based healthcare,” said Ron Kuerbitz, chief executive officer of agilon health.   “We know from experience that it is virtually impossible to effect a piecemeal migration out of fee for service care models and that even large, well-organized physician groups have a hard time making the full leap into value-based care.  By providing industry experience, process, technology platforms, capital and a value-based infrastructure, we are able to help them make the transition, and enable doctors to expand the capabilities they need to ensure the right care for each patient at the right time. My team at agilon health is driven by the opportunity to reduce physician burnout and to help physicians rediscover the joy of practicing medicine.”

Physicians from many of the U.S.’s largest medical groups have joined agilon health to help physicians improve quality and the patient experience.   “As a physician-led organization, our goal is to put the patient’s needs first and foremost, and our partnership with agilon health positions us perfectly to 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.

“We are in the process of expanding to other markets in the U.S. based on our unique physician-centric partnership model tailored for each local area,” said Ronald A. Williams, chairman of the board for agilon health. “The growth in risk-based models driven by growth in government lives such as Medicare and Medicaid, and pervasive physician dissatisfaction with the current system is creating a need to reinvent local health care delivery systems through aligned partnerships,” he said.  “We are finding that our partner physicians are very pleased to be able to expand their focus on comprehensive management of patient care with a partner to help manage the complex business of health care financing and administration.”

Based in downtown Long Beach, California, agilon health has expanded its operations in Honolulu, Hawaii and Corona, California, with newly opened offices in Columbus, Ohio, Fresno, California and Anaheim, California to support its growth.  In total, agilon health, with a staff of more than 500 professionals, is currently serving 1,800 primary care physicians, caring for more than 500,000 patients in five markets.

2018-12-27T19:03:25+00:00 November 1st, 2017|