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The Big Idea 2017-06-21T00:04:08+00:00

Partnership and Leadership

Success is built on strength. So we look for partners who are leaders in their markets. By combining their strengths with ours, we’re able to transform care even faster. Some of our leading partners:

Central Ohio Primary Care: the largest independent medical group in the country with 40 percent of the local market and significantly better than expected clinical outcomes

Vantage IPA: the most prominent Medicaid-focused IPA in California’s Riverside and San Bernadino counties

MDX Hawai’i: the largest organized delivery system for Medicare Advantage patients in Hawaii

All aspects of healthcare have both a clinical and business aspect. Having a significant input from both perspectives leads to better decisions and better outcomes for the population.
– Mary Cook, MD & Benjamin Shaker, Ohio Market Executive Leadership

The Market is Ready. Are you?

With consumer demand growing for more efficient, coordinated care, the market is ready for an Operating System that allows physicians to re-imagine the way healthcare is delivered. That’s why leading providers and payors are already exploring partnerships with agilon.

Two expanding markets we’re committed to serving:

Seniors: 1 in 3 seniors nationally are enrolled in Medicare Advantage. They are voting with their feet for an organized and coordinated system of care unavailable through traditional Medicare. As a result, health plans are increasingly seeking partners like agilon health to respond to these consumer demands.

Vulnerable Populations: Our partners serve thousands of Medicaid patients throughout central and southern California and are committed to expanding access to coordinated care in these communities. In fact, Medicaid health plan executives regularly reach out to discuss how we can support innovation and collaboration with their providers.

Model Delivery

To truly transform the delivery of care, there are a few critical philosophies agilon health partners and collaborators must embrace.

Provider partners: Philosophically must believe that moving to value-based care, and more specifically to risk-based contracts, is critical for long-term sustainability of the health care system and their physician organization.  Our model is built on partnership, so we can be flexible with what each party brings to the relationship and what capabilities are brought to the local market.

Health plans: Must embrace the idea that empowered physician organizations will optimally and sustainably influence healthcare quality and cost.

For re-engineering clinical care and creating institutional strength in physician practices that survives well beyond the physicians themselves, there’s no better model than delegated capitation.
-Ron Kuerbitz, Chief Executive Officer

Practice Made More Perfect?

The delegated capitation model has a lot of benefits for practicing physicians and the healthcare system as a whole.

– Delinking compensation from service volume allows us to incentivize team-based approaches for an increased patient base and improved outcomes.

– Outside of the fee-for-service environment, coordination of services, wellness programs and specialized services for patients with chronic conditions can be offered sustainably.

– Providers have access to total cost of care data for each patient (by service) for enhanced analytics and transparency.

– Physicians can coordinate care to ensure patients receive the best care at the lowest cost, creating efficiencies that can be fed back into innovative new patient programs.

A wonderful benefit to our partner physicians is the ability to focus less on the Fee For Service hamster wheel while being reinvigorated to adopt best practices and interventions that lead to the ideal outcomes that our patients truly deserve.
– Manoj K. Mathew, MD, SFHM (National Medical Director)

Scalable Outcomes

From executive experience and proprietary technology to scalable programs, every component of our purpose-built Operating System works together to help transform care delivery and improve outcomes.

Reinven t ion of Primary Ca r e Ch r onic Disease Iden t ifica t ion Administra t ive Services Acute/ Post-Acute Services Superior Specia l ist Network P R O P R I E T A R Y T E C H N O L O G Y P L A T F O R M + D A T A A N A L Y T I C S

Reinvention of Primary Care

We work hand in hand with our partners to implement a team-based, data-enabled approach. This allows primary care physicians to spend more time with the right patients, identify gaps in patient care and more proactively communicate with specialists.

For examples of the interdependencies with other aspects of our Operating System, see below.

Primary care physicians have a team dedicated to coordinating with a network of specialists to ensure seamless care.

Benefits from Administration Services: Primary care physicians have the data and insights to identify which patients they should be seeing and which patients need more services, reducing hospitalizations and other acute events. Unparalleled payor contracting expertise allows primary care physicians to practice at the top of their license.

Primary care physicians have the time to thoroughly evaluate patients, identify gaps and develop personalized care plans.

Our technology platform seamlessly connects clinical and administrative capabilities for optimal primary care under a global risk contracting model.

Chronic Disease Identification

Our Operating System combines proprietary technology, process, education and clinical leadership to help our partners identify and address gaps in care. This process is the cornerstone of developing individualized patient care plans.

For examples of the interdependencies with other aspects of our Operating System, see below.

Our technology and expertise in identifying and managing a patient’s burden of illness allows for coordination of care according to evidence-based guidelines.

Annual wellness exams and follow-ups are ensured through technology, support staff and processes to address gaps in care.

Our technology supports the fulfillment of quality measures and allows partners to document a patient’s burden of illness and gaps in care.

Administrative Services

agilon health has developed centralized resources to perform payor and network contracting, referral management, claims processing, data analytics and quality reporting.

For examples of the interdependencies with other aspects of our Operating System, see below.

Proprietary technology built specifically for the delegated capitation model powers our comprehensive administration services.

Our administration services enable primary care physicians to spend more time with the right patients, identifying gaps in patient care and proactively communicating with specialists.

Acute/Post-Acute Services

Our medical management models include hospitalists, extensivists, SNFists, case management, care transitions, alternatives to long-inpatient stays and increased use of ambulatory facilities. With our technology platform, primary care physicians and care managers have access to much needed price and quality transparency when making referrals.

For examples of the interdependencies with other aspects of our Operating

Primary care physicians are able to reduce re-admissions and overall hospitalizations through innovative care transition programs.

Superior Specialist Network

agilon health contracts a full network of specialists who are committed to evidence-based care guidelines and lowest cost sites of service. A critical differentiator in local markets, these specialists support a more coordinated care system and are compensated by an innovative model that rewards the specialists who generate the best overall outcomes.

For examples of the interdependencies with other aspects of our Operating System, see below.

Care transitions pre- and post-procedure are facilitated by a dedicated team of physicians and care managers.

Specialists assume leadership roles in developing and monitoring adherence to evidence-based guidelines for specialty care.

Purpose-built technology supports network contracting with specialists, adherence to evidence-based guidelines, and correct and timely processing of provider claims.

Our focus is high-quality, cost-effective care that physicians and their support teams can deliver to their communities in perpetuity. We recognize that bringing joy back to practicing medicine for primary care physicians is one of our guiding principles, as great things will follow when that occurs.
— Stuart Levine, MD, Chief Medical and Innovation Officer