agilon health, Physician Partners Educate Congressional Offices on Direct Contracting Model

On January 24, agilon health and the physician leaders from four partner practices, Bill Wulf, MD (Central Ohio Primary Care), Gary Pinta, MD (Pioneer Physicians Network), Kevin Spencer, MD (Premier Family Physicians), and Frank Civitarese, MD (Preferred Primary Care Physicians), collectively representing over 800 independent physicians, met with Congressional offices, the CMS Innovation Center, and the Department of Health and Human Services to discuss the Direct Contracting model.  This model is an advanced Accountable Care Organization-like offering from the Centers for Medicare & Medicaid Services (CMS) Innovation Center.  If properly designed and implemented, the Direct Contracting model has the potential to align capitated, coordinated care across traditional Medicare and Medicare Advantage programs.  agilon health, on behalf of a collaboration with 12 provider organizations, has submitted letters of intent to participate and is currently working on applications with the hopes of commencing in mid-2020 across 5-7 markets.

agilon health executives, Ron Kuerbitz (CEO) and Lisa Dombro (SVP, Innovation & Growth) were also present to share our views on Direct Contracting with policymakers in Washington DC. The Congressional meetings included the offices of Representatives Michael Burgess (R-TX), Mike Kelly (R-PA), and Senator Brown (D-OH).  At these meetings we shared information about the agilon health partnership model and our recent successes in improving care management and delivery for our senior population in Medicare Advantage.  We expressed our enthusiasm about the Direct Contracting model and our hope that it will enable us to align our work across Medicare Advantage and traditional Medicare.  We also provided feedback to the Democratic and Republican staffers for the Senate Finance Committee, one of the Congressional Committees with jurisdiction over traditional Medicare and Medicare Advantage payment issues.

In addition, we met with the CMS Innovation Center and the Department of Health and Human Services (HHS).  We shared our feedback on the Direct Contracting model, including specific suggestions for how it can be developed to ensure a balanced approach for organizations that have been committed to value-based care models for many years, as well as organizations that are new to value-based care in traditional Medicare.

We were greeted with a strong interest and enthusiasm for the transformational work that the leading practices on the agilon health platform are engaged in.  Collectively, we look forward to continuing to work with Congress and the Administration as the Direct Contracting model evolves.