agilon health Responds to the Centers for Medicare and Medicaid Services Request for Information on Proposed Direct Contracting Models

LONG BEACH, Calif., June 4, 2019 /PRNewswire/ — In response to a request for information from the Centers for Medicare and Medicaid Services (CMS), agilon health has submitted comments applauding the agency’s work on developing Direct Contracting models in traditional Medicare, while calling on CMS to ensure that new payment models adhere to certain guiding principles, including:

• Creating models which support high-performing physician practices as they expand access to traditional Medicare patients in their local communities through beneficiary engagement and payment design elements that align with the Medicare Advantage program.
• Encouraging and incentivizing the adoption of financial risk models along a progression from existing accountable care organizations and primary care models to delegated risk models, like the Global Direct Contracting option described in Primary Cares First.
• Protecting and empowering consumers by emphasizing the importance of the physician-patient relationship and providing Medicare beneficiaries with clear and detailed information about their Medicare coverage choices.

agilon health’s letter is intended to further inform the agency’s effort to design models within the Primary Cares Initiative, first announced in April. The new project advances Direct Contracting payment models in traditional Medicare. These models start with the premise that the primary care physician is central to the patient’s long-term engagement with the health care delivery system and consequently to a satisfying and high-quality care experience. These models will restructure the way that physicians and physician groups are paid, moving away from a broken fee-for-service system toward a system of greater financial and clinical accountability.

In the letter, Ron Kuerbitz, CEO of agilon health states, “We are committed to advancing models that allow physicians to focus on what matters most—providing high quality care to their patients.” The letter goes on to say, “Global risk delegated services models have been proven to be effective in improving population health and individual patient care in the Medicare Advantage program, Medicaid programs and commercial plans. The Direct Contracting models are a step toward achieving the benefits of this model for physicians and patients in traditional Medicare.”

agilon health physician practice partners in Austin, Texas, Akron, Ohio and Columbus Ohio, representing 400 primary care physicians and over 50,000 traditional Medicare beneficiaries, also submitted their comments to the agency. Dr. Gary Pinta, practicing internist and President of Pioneer Physicians Network in Akron, suggested that “Aligning the model to Medicare Advantage is particularly important for benchmarking, risk adjustment and quality measurement reporting.  Creating consistency across programs will allow us to reduce burdens, make the program more easily understandable, and allow us to make consistent investments across our entire Medicare population. We encourage the agency to consider how alignment to the Medicare Advantage benchmark could create stronger incentives for efficient, high-quality provider organizations to participate in the Direct Contracting global model.”

CMS is expected to release further details about the Direct Contracting models later this summer.

Read the agilon health comment letter.

About agilon health
Founded in 2016, agilon health is a platform that empowers physicians with the operating model, technology, solutions and capital required to transition from fee-for-service to integrated payment and delivery. Through agilon health’s innovative physician-first partnership model, primary care physicians can lead the transformation of their local markets through value-based care, expand their long-term growth opportunity, share best practices with like-minded physicians, and recapture the joy of practicing medicine. Since its inception, more than 1,800 primary care physicians, including numerous thought-leading independent physician organizations, have partnered through the agilon health platform to redesign the system of care for more than 360,000 patients.

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SOURCE agilon health