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New Survey Shows Central Ohio Primary Care Physician Satisfaction Rivals Consumer Loyalty to Beloved Corporate Brands

Columbus, OH, October 10, 2018— At a time when substantial numbers of primary care physicians are disgruntled about their work environment, and physician burnout reaches an all-time high, a recent survey of the physicians at Central Ohio Primary Care (COPC) showed they are more satisfied and loyal than customers of some of the nation’s most beloved corporations.

The survey showed COPC’s Net Promoter Score* of 85 is higher than Apple and Southwest Airlines. In fact, the only constituents who appear to be more loyal than COPC physicians are the owners of a Tesla automobile.

But for most primary care physicians the picture isn’t so rosy. An editorial published in the Journal of General Internal Medicine reported burnout rates ranging from 30 to 65 percent across physician specialties, with the highest rates for those in emergency medicine and primary care. And a survey of 950 primary care physicians conducted by MDVIP, a national network of primary care physicians who focus on patient-centered medicine, revealed 83 percent of doctors are spread so thin they don’t have time with their patients.

COPC’s journey to creating happier physicians started with a culture shifting from fee-for-service to value-based care, a model used in every aspect of their practice. To add to this initiative, the physician group executed a plan focusing on the “quadruple aim”: quality of care, physician satisfaction, patient experience, and efficiency of care.

“Every physician wants to work in an environment where his or her time and input valued” commented David Neiger, COPC primary care physician.  “COPC provides that and more. Physicians have a say in the direction of the practice.  In fact, 80 percent of them are financially rewarded as shareholders.  COPC also offers a delivery system specifically built for seniors through partnerships with local Medicare Advantage plans.  These value-based care programs allow me to spend more quality time with my patients.”

COPC management, including hands-on CEO Dr. Bill Wulf, points to the other reasons why his group’s physicians are happier at work:

  • Physicians have always been involved in COPC’s decision-making process. One physician representative from each of the 67 offices attends a monthly advisory committee meeting.
  • COPC physicians are less stressed because their overall compensation is increasingly tied to the quality of care scores instead of the number of patients they manage. Furthermore, COPC patients adhere to recommended preventive care screenings and immunizations at industry-leading rates.
  • They are also taking advantage of ancillary staff, such as nurse practitioners, to provide important preventive care to patients.
  • COPC has also entered into a long-term partnership with agilon health, a consultant that assists with the growth and development of a purpose-built care delivery program for Medicare Advantage patients.

“The promise of value-based care is reflected in the satisfaction of COPC physicians because it offers them increased time at the bedside and reduces the burden of paperwork,” admits Dr. Amy Nguyen Howell, chief medical officer at America’s Physician Groups, the nation’s leading association representing physician organizations that practice capitated, coordinated care. “By embracing this model, COPC has invested not only in its physicians but also in the patients and communities they serve.”

And happy doctors go hand in hand with happy patients. A recent survey of COPC patients’ who underwent an annual wellness visit confirms their satisfaction.

Vicki Spencer has been getting regular exams from Dr. Henry Sleesman, a COPC internist at Riverside Medical Group, for more than 30 years.  “He is not only an excellent physician but also a wonderful man who cares about and spends quality time with his patients,” she admits. “He remembers everything about my family and I can talk to him about anything.  After my yearly health exam, he makes a personal call to tell me the results of my blood tests. He always goes the extra mile.”

COPC has also been widely recognized for its commitment to quality and efficiency of care. The physician group created an award-winning program that has significantly reduced the number of patients utilizing emergency care. Their patients have also benefited from a reduction in skilled nursing facility (SNF) utilization, as COPC hospitalists have effectively discharged more patients directly to their homes. These results clearly demonstrate that COPC is keeping quality patient care at the forefront of their initiatives.

*Net Promoter Score (NPS) is a management tool that can be used to gauge the loyalty of a firm’s customer relationships and is also used to gauge employee satisfaction. NPS has been widely adopted with more than two-thirds of Fortune 1000 companies using the metric.

 

About Central Ohio Primary Care (COPC)

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 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 six U.S. markets.

 

2018-10-15T16:48:36+00:00 October 15th, 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.

2018-10-09T19:32:38+00:00 October 9th, 2018|

agilon health achieves a 20 percent boost in closing care gaps by using physician and member incentives for preventive care

LONG BEACH, Calif. (August 29, 2018) – agilon health, which helps physicians and medical groups manage the leap from fee-for-service to value-based care by providing financial, organizational and operational tools, has released its 2017 outcomes report that revealed it closed about 20 percent more gaps in care with a partner IPA in the Inland Empire that serves Medicaid enrollees.

By implementing teams of member quality specialists to increase participation in preventive services such as screenings and annual health checks, agilon health closed more than 65,000 gaps in care during 2017 for its Inland Empire-based Medicaid patients, the report highlights.   Based upon this initial success, the most effective tactics have now been implemented across agilon health’s entire Medi-Cal population, which extends into the Central Valley.

“Gaps in care push up costs for Medicaid patients,” said Ronald Kuerbitz, chief executive officer, agilon health. “If patients do not get preventive services, they will more likely need costlier specialty or acute care down the road.  More importantly, preventive care saves lives.”

By using unique incentives, improved communications and proprietary data collection tools for both the participating physicians and members to improve adherence with preventive services, agilon health achieved remarkable outcomes for Medicaid members, which traditionally have been reluctant to participate in preventive care services.  More than $1 million was distributed as bonuses to participating agilon physicians that closed care gaps, and more than $60,000 was spent on gift cards which were used as an incentive for members.

“The fact is, incentives are quite effective in engaging both the physicians and members in preventive care compliance,” said Manoj Mathew, MD, National Medical Director, agilon health.  “If all it takes is offering a $25 Target gift card to incentivize a woman to come in and get her mammogram, we can influence health care behavior that can save lives. It is a small investment to ensure long-term quality of care and a better quality of life for our members, the majority of whom are from underserved communities.”

The screening and health check performance for 2017 highlights the outcomes for breast cancer screening, diabetic eye screening, cervical cancer, childhood immunizations, adolescent immunizations, diabetic glucose monitoring, medication management, timely prenatal care, timely postpartum care and well-child visits.

Among the more notable outcomes for 2017 included agilon health’s quality performance for its diabetic members.  Eye screening adherence increased from 38 percent in 2016 to more than 50 percent for 2017. Glucose level screening increased from 42 percent to more than 50 percent during the same period.  In November of 2017, agilon health invested in two RetinaVue imaging devices.  By using telehealth resources with trained ophthalmologists, they were able to bring retinal eye screenings directly to its members through local IPA physician offices.  Through this service, eye diseases, such as macular degeneration and glaucoma, were identified early and members have been referred for further evaluation.

Besides introducing a new proprietary technology platform in 2017 that improved workflow, quality data collection, and reporting, agilon health increased its quality care team to nine professionals who work daily on member engagement and care coordination.

To review the details of agilon health’s quality outcome report for 2017, please visit https://agilonhealth.com/outcomes.

 

2018-08-29T19:35:07+00:00 August 29th, 2018|

Our Culture of High Integrity and Compliance

As part of our ongoing work to centralize and standardize our claims payment operations into a single, high-functioning department, we identified practices in the claims audit processes of our legacy California operations that require remediation.  We immediately, and without hesitation, disclosed these claims issues to the California Department of Managed Health Care (DMHC) and our plan partners in February 2018 and engaged outside experts to conduct a thorough investigation.  This voluntary self-disclosure reflects our singular commitment to compliance and our integrity as leaders in care delivery.

Since then, we have met in person with DMHC, completed our claims process investigation, taken steps to fully remediate those processes and have supported numerous health plan audits.  We remain committed to our physician partners and members in California and continue to make significant progress in the implementation of our new MSO, and quality systems in the California market. These initiatives include:

  • The appointment of highly experienced leadership at the MSO;
  • The implementation of enhanced controls and management oversight of our legacy system;
  • The adoption of an accelerated timeline for the movement to CORE, our new operating system; and
  • Visits to over 100 primary care providers in May, which featured the delivery of comprehensive quality program toolkits that were well received across the board.

As of today, some audits are on-going and we are actively engaged in constructive and transparent remediation efforts with our contracted health plan partners.  Just as we have promised to do with the DMHC, we will keep you fully updated on our progress toward full remediation of all audit issues.

We are particularly grateful for the opportunity to continue to collaborate in California with Aetna, Anthem Blue Cross, Blue Shield, Brand New Day, Care1st, Health Net, Humana, and Molina.  We value these relationships and look forward to many years of successful collaboration with these plans in service to their members.  As some of you may know, however, IEHP has decided to terminate our contract effective August 31, 2018.   We regret that IEHP has felt it necessary to take this action, but our first concern is that we minimize adverse impacts on the members.  We are committed to work collaboratively with IEHP on its block transfer process and to ensure continuity of care.

I would like to recognize and thank the California team for their tireless commitment to our physician partners and members.  We know many of our employees live in the Riverside and San Bernardino communities we serve and are honored to be serving their neighbors, friends, and families. We all hold that trust and responsibility in high regard.

And while strength in California remains critical and is a testament to our history, the future of agilon health is also defined by our growing network of providers and members in Hawaii, Ohio, and Texas as well as new markets yet to come.  Today, we collaborate with approximately 1,000 primary care physicians outside of California who are partnering with us to care for over 65,000 Medicare Advantage members.  We continue to build our organization across the country to fulfill our promise of higher quality, more connected care for our partners and members across the country.

 

 

 

 

2018-06-06T01:31:50+00:00 June 6th, 2018|

Protecting a Reputation of High Moral and Ethical Standards

“A good reputation is hard-won and easily lost. But the lost reputation has invariably been given away by the actions of the holder, rather than been taken away by somebody else.”
– C. Beveridge

In a very short period of time, agilon health has established and enjoys a very positive reputation across our industry.  This reputation rests on all of our shoulders and is the direct result of the good work we all do day in and day out.  In these holiday months when we are reminded of all of our blessings and show our appreciation to those who mean so much to us, I want you to know that I feel it is a privilege to work with you on such an important endeavor and I thank you for your commitment to agilon health.  Your hard work and relentless pursuit of enabling our physicians to provide high quality and efficient health care to our members have already brought us very positive recognition at a national level.  Our reputation influences so many aspects of our company – the way our physician customers and partners value our services; whether or not health plans choose to contract with us and entrust their members to us; how regulators perceive us; and whether employees find agilon health a fulfilling place to work.  A strong reputation will fuel growth and future success.  We should not take it for granted.  Therefore, it is important for all of us to protect our reputation through a strong culture of integrity and ethical conduct.

As part of our evolution as a high performing organization which brings people, solutions, capital, and technology to enable primary care physicians to achieve long-term success, we have recently adopted a Code of Conduct that applies to all of us.  All employees of agilon health are responsible for knowing the Code of Conduct and for abiding by high legal, ethical and moral standards.  Every employee of agilon health is also required to be familiar with and comply with all federal and state laws, rules, and regulations that govern their role within the organization. If you are unfamiliar with what those rules are, it is your obligation to ask.  Not knowing the rules, or turning a blind-eye into activities you are not comfortable with is not acceptable and violates our Code of Conduct.

Whether you work in California, Hawaii or Ohio and no matter what your contributions and responsibilities are within the organization, we are all accountable for upholding these principles and behaviors in accordance with the highest of ethical and legal standards. Our Code of Conduct obligates us to avoid any conduct that even raises the appearance of impropriety and to hold ourselves to even higher ethical standards than the legal rules require.  It is also important that we recognize that breaches of the Code of Conduct will be taken seriously.

The Code of Conduct is now available on the agilon health website by clicking here.  In addition, all managers will receive a copy of the Code of Conduct and are expected to review it with their teams in December.  Given the importance of the Code of Conduct to all of us and the way that we do business, I trust you will read it with due care and attention. If you have any questions, are unsure about a particular policy or compliance issue, or believe, or even are just uncertain whether the Code of Conduct has been broken by anyone in the organization we urge you to speak to your supervisor or call the Compliance Hotline at 833-668-8638.  Asking questions and raising issues helps make us all smarter and more effective.  With your help, I am confident that our reputation will be upheld long into the future.

 

2018-02-26T21:15:12+00:00 December 15th, 2017|

agilon health In The News: agilon health Receives National Media Attention for the Quality Improvement Work.

Dangling A Carrot For Patients To Take Healthy Steps: Does It Work?

Patricia Alexander knew she needed a mammogram but just couldn’t find the time.

“Every time I made an appointment, something would come up,” said Alexander, 53, who lives in Moreno Valley, Calif.

Over the summer, her doctor’s office, part of Vantage Medical Group, promised her a $25 Target gift card if she got the exam. Alexander, who’s insured through Medi-Cal, California’s version of the Medicaid program for lower-income people, said that helped motivate her to make a new appointment — and keep it.

Health plans, medical practices and some Medicaid programs are increasingly offering financial incentives to motivate Medicaid patients to engage in more preventive care and make healthier lifestyle choices.

They are following the lead of private insurers and employers that have long rewarded people for healthy behavior such as quitting smoking or maintaining weight loss. Such changes in health-related behavior can lower the cost of care in the long run.

“We’ve seen incentive programs be quite popular in the insurance market, and now we are seeing those ramp up in the Medicaid space as well,” said Robert Saunders, research director at the Margolis Center for Health Policy at Duke University.

Medicaid patients who agree to be screened for cancer, attend health-related classes or complete health risk surveys can get gift cards, cash, gym memberships, pedometers or other rewards. They may also get discounts on their out-of-pocket health care costs or bonus benefits such as dental care.

Under the Affordable Care Act, 10 states received grants totaling $85 million to test the use of financial rewards as a way to reduce the risk of chronic disease among their Medicaid populations. During the five-year demonstration, states used the incentives to encourage people to enroll in diabetes prevention, weight management, smoking cessation and other preventive programs. The states participating were California, Connecticut, Hawaii, Minnesota, Montana, Nevada, New Hampshire, New York, Texas and Wisconsin.

Medi-Cal, for example, offered gift cards and nicotine replacement therapy to people who called the state’s smoking cessation line. Minnesota’s Medicaid program handed out cash to people who attended a diabetes prevention class and completed bloodwork.

An evaluation of these programs, released in April, showed that incentives help persuade Medicaid beneficiaries to take part in such preventive activities. Participants said gift cards and other rewards also helped them achieve their health goals. But the evaluators weren’t able to show that the programs prevented chronic disease or saved Medicaid money. That’s in part because those benefits could take years to manifest, according to the evaluation.

Overall, research on the effectiveness of financial incentives for the Medicaid population has been mixed. A report this year by the Center on Budget and Policy Priorities found that they can induce people to keep an appointment or attend a class but are less likely to yield long-term behavior changes, such as weight loss. And in some cases, the report said, incentives are given to people to get exams they would have gotten anyway.

The center’s report also found that penalties, including ones that limit coverage for people who don’t engage in healthful behaviors, were not effective. Instead, they can result in increased use of emergency rooms by restricting access to other forms of care, the report said.

Some of the biggest factors preventing Medicaid patients from adopting healthful behaviors are related not to medical care but to their circumstances, said Charlene Wong, a pediatrician and health policy researcher at Duke University.

That makes administering incentive programs more complicated. Even recruiting and enrolling participants has been a challenge for some states that received grants through the Affordable Care Act.

“The thing that is most likely to help Medicaid beneficiaries utilize care appropriately is actually just giving them access to that care — and that includes providing transportation and child care,” said Hannah Katch, one of the authors of the report by the Center on Budget and Policy Priorities. Another barrier is being able to take time off work to go to the doctor.

But health plans are eager to offer patients financial incentives because it can bring their quality scores up and attract more enrollees. And medical groups, which may receive fixed payments per patient, know they can reduce their costs — and increase their profits — if their patients are healthier.

Providing incentives to plans and medical groups has created a business opportunity for some companies. Gift Card Partners has been selling gift cards to Medicaid health plans for about five years, said CEO Deb Merkin. She said health insurers that serve Medicaid patients want to improve their quality metrics, and they can do that by giving incentives and getting patients to the doctor.

“It is things like that that are so important to get them to do the right thing so that it saves money in the long run,” she said.

Agilon Health, based in Long Beach, Calif., runs incentive programs and other services for several California medical groups that care for Medi-Cal patients. The medical groups contract with the company, which provides gift cards to patients who get mammograms, cervical cancer exams or childhood immunizations. People with diabetes also receive gift cards if they get their eyes examined or blood sugar checked. And the company offers bonuses to doctors if their Medicaid patients embrace healthier behaviors.

The incentives for patients are “massively important for the Medicaid population, because the gaps in care are historically so prevalent,” said Ron Kuerbitz, CEO of Agilon. Those gaps are a big factor pushing up costs for Medicaid patients, because if they don’t get preventive services, they may be more likely to need costlier specialty care later, Kuerbitz said.

Emma Alcanter, who lives in Temecula, Calif., received a gift card from her doctor’s office after getting a mammogram late this summer. Alcanter, 56, had noticed a lump in her breast but waited about two years before getting it checked, despite reminders from her doctor’s office. “I was scared they were going to find cancer,” she said.

Alcanter finally decided to get screened after her first grandchild was born. The gift card was an added bonus, and Alcanter said it showed her doctors cared about her. Her mammogram revealed that the lump wasn’t cancer, and she plans to use the gift card to buy a present for her grandson.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

2017-12-13T19:05:19+00:00 December 5th, 2017|

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.

2017-11-07T17:10:13+00:00 November 1st, 2017|

Golden Valley Health Centers Launches Sequoia Health, a New Populations Health Management Joint Venture, with agilon health.

GOLDEN VALLEY HEALTH CENTERS LAUNCHES SEQUOIA HEALTH, A NEW POPULATION HEALTH JOINT VENTURE, TO EXPAND AND IMPROVE CARE TO CENTRAL VALLEY UNDERSERVED PATIENTS

Transformative Joint Venture with agilon health enables Golden Valley Health Centers To Focus on Prevention and Highly Coordinated Clinical Care and Access New Payment Model

 

Merced, CA (November 1, 2017) – Golden Valley Health Centers (GVHC), one of central California’s largest non-profit network of community health centers that provide care for thousands of underserved patients, has partnered with agilon health of Long Beach, California, to launch Sequoia Health, a new entity that will allow GVHC and other high-quality providers to offer a provider-led, value-based, population health program that improves access and quality care for the patients they serve.

Serving more than 150,000 patients through its network of 29 clinics, GVHC is one of the largest medical providers to Medi-Cal patients in the Central Valley. GVHC will continue to operate as it always has and the brand will not change. Sequoia Health will enable GVHC and other providers to participate in a population health program by providing contracting, data collection and management, care coordination, clinical programs and administrative services.

The nation’s health care system continues to transition from the fee-for-service model that rewards the volume of services a provider delivers, to a more value-based approach. Organizations like Sequoia Health, which offer risk-bearing population health programs that provide efficient coordinated clinical care and expanded access to high-quality care for vulnerable populations, allow providers like GVHC to stay ahead of the curve.

“Sequoia Health is a unique partnership with agilon health that will create a new footprint in how we expand and serve our patients,” said Tony Weber, Chief Executive Officer of GVHC, which is headquartered in Merced. “This new model puts the patient at the center of our clinical care model, with our dedicated care teams working side-by-side to ensure that each patient gets the appropriate care at the right place at the right time. This is an exciting new model for GVHC because it allows us to direct locally the dollars that are spent on the right care to meet the needs of our community. Moreover, it will allow us to recruit additional high performing providers and add more resources to improve access to high-quality care. “

GVHC’s partner in Sequoia Health is agilon health, a Long Beach, California-based company that serves nearly 500,000 Medi-Cal members, is investing capital and bringing resources in technology-enabled clinical, operational and administrative expertise that help independent organizations like GHVC to transition into value-based health care. “In Golden Valley Health Centers, we found a like-minded partner which has a rich history of providing great medical, behavioral, and dental care to the underserved,” said Manoj Mathew, MD, agilon health’s Market President for California. “GVHC is an ideal partner to embrace a transformative payment model which puts overall control for patient care back into the hands of physicians and care teams. Patients will benefit greatly with a focus on prevention and highly coordinated clinical care.”

The concept of highly coordinated care is effectuated through efficient processes, systems, and data that enables intense collaboration between doctors, nurses, assistants and other allied health care team members such as social services and specialists among others. In a population health model, preventive care is the flagship focus.

“This new partnership will allow Golden Valley Health Centers to expand existing efforts to provide high-quality cost-effective care to our patients. Through increased focus on clinical metrics such as childhood immunizations, age-appropriate well-child visits, preventative care screenings for breast and colon cancer as well as improved focus on the care of chronic diseases such as diabetes and hypertension, Sequoia Health will improve not just the care of our individual patients but of the entire community” said Ellen Piernot MD, MBA, Chief Medical Officer for Golden Valley Health Centers.

“Through GVHC’s participation in Sequoia Health, our team is responsible both financially and clinically for the health of each patient. Sequoia Health will partner with us to develop local programs to ensure higher quality health care, including programs that prevent people from needing emergency room care and help them remain independent in their homes. We value the trust our partners have shown in our ability to improve the health status of our communities,” added Weber.

In its launch, Sequoia Health has contracted with Health Net, a large California health plan that provides and administers health benefits to many Medi-Cal enrollees, as its first partner in this new model.

For more information, click www.SequoiaHealthIPA.com

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2017-11-14T23:58:44+00:00 November 1st, 2017|

Introducing COPC Senior Care Advantage, the joint venture between Central Ohio Primary Care Physicians and agilon health

October has been a tremendous month, in which we together delivered very tangible accomplishments across the organization. These ongoing achievements, that I have the pleasure of highlighting each month, don’t belong to any individual. Rather they are the product of the good work all of you perform together each day. A reputation of enabling high-quality care, efficient processes, and speed to execution is critical to our ongoing success. I thank you for the strength of our reputation we are building on each day. We should all thank the teams that are striving to respond to customer calls faster than we’ve ever done before, focusing on processing referral authorizations with increased precision, and ensuring our physician partners receive timely and accurate payment for the good work and services they provide our members. These are the activities that build a strong, durable and admired organization and provide a reputation that enables future success.

This month’s focus is deservingly directed toward the newest agilon health market: Columbus, Ohio. Over the course of the last ten months, the local market team collaborated with enterprise-based colleagues in Long Beach, Corona and now Anaheim, to develop an operational and clinical model designed to transform the healthcare delivery system and launch an innovative new program called COPC Senior Care Advantage.

It is with great pleasure that I announce the launch of COPC Senior Care Advantage, the joint venture between Central Ohio Primary Care Physicians, the nation’s largest independent, physician-owned primary care practice and agilon health. COPC Senior Care Advantage is a new population health management program designed to improve the quality, value, efficiency, patient experience and outcomes for COPC’s Medicare Advantage patients. It is made possible through risk-based agreements with Aetna, Anthem, Humana, and MediGold, all of which were signed in the last four weeks. Executing risk-agreements, in a market that is unaccustomed to the healthcare delivery models we all take for granted in California, is no easy feat, even with the support and commitment of an incredible partner in COPC. Please join me in recognizing the contracting team that has paved the way for transforming the central Ohio market:

Market-based team
Ben Shaker, Ohio Market President
Mary Cook, MD, Ohio Market Medical Director
William Wulf, MD, CEO Central Ohio Primary Care Physicians

Enterprise team
Elizabeth Russell, Chief Payment Transformation Officer
Myong Lee, VP HMO Contracting
Ted Halkias, Chief Financial Officer
Maria Adams, Consultant
Katie Kauachi, VP, Payor Contract Analysis

I can’t underscore enough the importance securing these risk-based contracts in Columbus, Ohio holds for the future of our organization. Bringing new payment models to communities across the country will fuel the transformation of the delivery system and enable physicians to bring the right care to each patient at the right time. I know you all are motivated by this promise like I am. I invite you to enjoy a short, inspiring, video clip featuring Dr. Wulf and a COPC patient who has joined us in celebrating the launch of COPC Senior Care Advantage on a local news station by clicking here

 

 

 

2017-10-30T19:27:39+00:00 October 30th, 2017|

Central Ohio Primary Care Physicians and Area Medicare Health Plans Partner Through COPC Senior Care Advantage To Launch New Population Health Management Model to Revolutionize Care for Medicare Members in Central Ohio

COPC Senior Care Advantage Will Focus on Prevention and Highly Coordinated Care delivered through a Team of Experts to Improve the Health and Wellness of Medicare Advantage Patients in a Value-Based, Population Health Model.

To revolutionize the care it provides its Medicare Advantage patients, Columbus-based Central Ohio Primary Care (COPC), the largest physician-owned independent primary care medical group in Ohio and the largest in the U.S., has entered into an agreement with local and national Medicare Advantage plans through COPC Senior Care Advantage, a new population health management program designed to improve the quality, value, efficiency, patient experience and outcomes of Medicare Advantage patients.

COPC Senior Care Advantage will commence transforming care for Medicare Advantage patients beginning in January of 2018, thanks to new population-health based contracts with all Aetna Medicare Plans (HMO/PPO), Anthem Mediblue Dual Advantage, Anthem Mediblue Access, Anthem Mediblue Access Enhanced, Anthem Mediblue Access Core, Anthem Mediblue Access Basic, Humana Gold Plus HMOs and HumanaChoice PPOs, MediGold Classic Preferred (HMO), MediGold Essential Care (HMO), MediGold Flexible Choice (PPO) and MediGold Medical Only (HMO). COPC is also contracted with other Medicare Advantage plans through legacy agreements.

“As a physician-led organization, our goal is to put the patient’s needs first and foremost, and this program by COPC Senior Care Advantage will 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, which has more than 350 providers and 62 practice locations throughout central Ohio. “This new model will be coordinated care on steroids,” said Dr. Wulf, a long-time advocate for value-based care. “COPC Senior Care Advantage is an innovative population health model designed to provide higher quality, more efficient care for local Medicare Advantage patients,” said Ben Shaker, President of COPC Senior Care Advantage. “Through this collaboration with COPC, we are taking the value-based model to a new level of health and wellness by focusing on prevention and highly coordinated clinical care.”

By partnering with like-minded Medicare health plans, COPC Senior Care Advantage will be accountable for improving the health care of COPC’s Medicare Advantage patients. Under this model, the physicians at COPC will coordinate all of the care for enrolled members, including primary care, specialists, major local health systems and hospitals, laboratories and all of the ancillary services necessary to improve the health status of such members. They will also engage in advanced data analytics to support clinical decisions, ensuring that the appropriate care is delivered at the right time and place.

“We believe that more efficient care is possible if physicians assume both clinical and financial responsibility for patient care. By having robust data and increased resources at their fingertips, COPC physicians will be better able to deploy highly integrated, prevention-oriented care. Better outcomes are possible when innovative clinical programs are supported by actionable and timely data,” said Ben Shaker.

The COPC Senior Care Advantage program is designed to allow COPC physicians to spend more time with their patients. “Taking care of senior patients is more complicated than ever before given the prevalence of chronic illness among this population. Through this new arrangement, COPC Senior Care Advantage will be supporting COPC physicians with case managers, social workers, nurses and quality assurance staff,” said Dr. Wulf. “The purpose is to allow our doctors to spend more time with patients, providing support, counseling and prevention services to help patients remain independent and improve their health.”

Across the country, health care officials are seeking ways to change the health care system from one that rewards the volume of services doctors provide to one that rewards high quality and value. The goal is to offer better quality care and save money by providing the right level of care at the right time with a focus on prevention. If patients are healthier, they are less likely to need expensive hospitalization or emergency care.

“This is an innovative approach to medical care for seniors, one that would benefit our members for years to come,” said Michael Vincent Smith, MD, FACC, FACS, FCCP, Regional Vice-President, Medical Director, Central Region Medicare, Anthem, Inc., one of the Medicare Advantage plans partnering with COPC Senior Care Advantage. “This new partnership has the potential to improve health outcomes and keep costs down for both members and health plans, particularly for those members who suffer from such prevalent chronic illnesses such as congestive heart failure, diabetes, COPD and hypertension. We are very excited to be a lead partner in this new model of care for our Medicare Advantage members.”

After more than a year of planning and staff additions, COPC Senior Care Advantage brings together multiple health care providers and health plans under a program dedicated to transform the health and wellbeing of Medicare Advantage members in the greater central Ohio area. The COPC Senior Care Advantage program through COPC will be available beginning January 1, 2018 for all Medicare Advantage members of participating health plans. For more information about COPC Senior Care Advantage, please visit www.COPCseniorcareadvantage.com

2017-10-23T16:28:31+00:00 October 23rd, 2017|
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