March 11, 2020, Long Beach, CA – agilon health, in conjunction with nine independent physician practice partners, applied to participate in the Centers for Medicare and Medicaid Services (CMS) Innovation Center Direct Contracting model. The model is aimed at reducing expenditures and enhancing the quality of care for seniors in fee-for-service Medicare. The applications represent potential participation by over 500 primary care doctors providing care to 78,000 fee-for-service Medicare patients in five 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 for patients. The model seeks to align payment models across traditional Medicare and Medicare Advantage, creating efficiencies for physician practices. Furthermore, the ability to offer enhanced benefits gives Direct Contracting model participants additional tools to improve patient care.
“We see tremendous potential for the Direct Contracting model to improve the quality of care for seniors in traditional Medicare while alleviating the burden for primary care physicians. This model places our primary care physician partners at the center of the health care system and will drive a patient-centered approach in traditional Medicare. Our applications demonstrate a robust commitment to advancing and fulfilling the promise of value-based care models, like Direct Contracting, for our physician partners and their senior patients,” said Ron Kuerbitz, Chief Executive Officer, agilon health.
CMS announced the Direct Contracting model as part of the agency’s Primary Cares Initiative in April 2019. The initial phase of the program is scheduled to begin in July 2020, and CMS is expected to release additional details about the model later this year. “We look forward to continuing to work with the federal government to design and implement this model going forward,” Ron continued.