agilon health Reports ACO REACH Model Results for 2022 Performance Year

By: agilon health, inc. via Business Wire

October 23, 2023 at 16:10 PM EDT

agilon REACH ACOs achieved $107 million in gross savings and 99.8% quality score

agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, announced that its Accountable Care Organizations (ACOs) achieved $107 million in gross savings (9.7% gross savings rate), including $24 million savings to the Medicare Trust Fund, during the 2022 performance year of the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model. agilon’s eight REACH ACOs operate under global risk and are responsible for the total cost and quality of approximately 90,000 Medicare Beneficiaries.

“agilon health and our physician partners are committed to sustaining local primary care by improving outcomes, cost-efficiency, and health equity for seniors through participation in full-risk models like the ACO REACH model,” said Steve Sell, chief executive officer, agilon health. “As the only full-risk program available in Traditional Medicare, ACO REACH demonstrates what’s possible when primary care physicians take accountability for the total cost and quality of their patients’ health care.”

agilon’s REACH ACOs achieved a quality score of 99.8%, with 7 of 8 REACH ACOs achieving a 100% quality score during 2022 performance year. agilon REACH ACOs performed better than mean performance across all four quality measures including: All Condition Readmissions, Unplanned Admissions for Patients with Multiple Chronic Conditions, Timely Follow Up, and the CAHPS Patient Experience Survey.

“Our practice operates in a rural community in Southeastern Ohio and 40 percent of our Senior Care ACO patients live in very socioeconomically challenged areas,” said Patrick Goggin M.D., vice president, Physicians Group of Southeastern Ohio (PGSEO) and medical director, Ohio Senior Care ACO. “Through our partnership with agilon health and the shared savings generated from our participation in full-risk programs including ACO REACH, we have been able to invest in much needed care management infrastructure and technology which has created a vastly improved care experience for our patients.” PGSEO serves over 9,000 Medicare beneficiaries in Southeastern Ohio and achieved $15.4 million gross savings (12.5% gross saving rate) for the 2022 performance year.

agilon’s REACH ACOs include 1,500 primary care physicians operating across 12 communities in Hawaii, New York, North Carolina, Ohio, Pennsylvania, and Texas. Since joining the ACO REACH model in 2021, agilon’s REACH ACOs have achieved $130 million in gross savings including $33 million in savings to Medicare.

About the ACO REACH Model

The ACO Realizing Equity, Access, and Community Health (REACH) Model encourages health care providers — including primary and specialty care doctors, hospitals, and others — to come together to form an Accountable Care Organization, or ACO. ACOs break down silos and deliver high-quality, coordinated care to their patients, improve health outcomes, and manage costs. For questions about the REACH ACO Model, call 1-800-MEDICARE (1-800-633-4227), TTY 877-486-2048. For questions about agilon’s Senior Care ACOs, call 866-407-1660, 8 am – 5pm PST.

About agilon health

agilon health is the trusted partner empowering physicians to transform health care in our communities. Through our partnerships and purpose-built platform, agilon is accelerating at scale how physician groups transition to a value-based Total Care Model for senior patients. agilon provides the technology, people, capital, process, and access to a peer network of 2,700+ PCPs that allow physician groups to maintain their independence and focus on the total health of their most vulnerable patients. Together, agilon and its physician partners are creating the healthcare system we need – one built on the value of care, not the volume of fees. The result: healthier communities and empowered doctors. agilon is the trusted partner in 30+ diverse communities and is here to help more of our nation's leading physician groups and health systems have a sustained, thriving future. For more information visit www.agilonhealth.com and connect with us on Twitter, Instagram, LinkedIn and YouTube.

The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.