Partner Referral Councils Provide Insight to Physician Specialists Who Deliver High-Value Care
A new high-value referral program, which has launched in several markets including Akron adn Southeastern Ohio, is proving that historically, the most recommended specialty physicians may not necessarily be the most effective and efficient.
Using data analytics and in partnership with physician partners, data is made available to PCPs to inform referrals to high-value and high quality specialty providers to ensure patients receive medically necessary care in the most cost-effective manner.
A referral council that includes physicians partners and representatives from agilon health finance, analytics, and actuarial teams provide data and insight to help guide PCPs as they refer patients to specialists. Whether the physicians specialize in cardiology, orthopedics, nephrology, pulmonology, etc. the referral council’s assigned rankings reflect specialists who have proven to deliver high value care in an economical manner.
Claims data showed a four times greater difference between the very highest quality, most-efficient providers and those at the bottom tiers. agilo health’s Chief Medical and Quality Officer, Ben Kornitzer, M.D., is optimistic that the partner-based referral councils are enhancing the understanding of differences in quality and efficiency of care across specialists and increasing the frequency in which our primary care physicians are referring to the highest quality specialists in the market.