agilon health Reports ACO REACH Model Results for 2023 Performance Year

By: agilon health, inc. via Business Wire

November 12, 2024 at 08:30 AM EST

In 2023, agilon REACH ACOs achieved $150 million in gross savings and 95% quality score

Since joining the model in 2021, agilon REACH ACOs achieved $281 million in gross savings, including $71 million in savings to Medicare Trust Fund

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 $150 million in gross savings (13% gross savings rate), including $37 million savings to the Medicare Trust Fund, during the 2023 performance year of the ACO Realizing Equity, Access and Community Health (ACO REACH) model. agilon’s eight REACH ACOs operate under full risk, and in 2023 were responsible for the total cost and quality of care for approximately 90,000 Traditional Medicare beneficiaries.

“Through participation in full-risk models, agilon health is helping physician partners across the U.S. make the shift from volume to value, which is enabling better care for seniors, lower costs and improved health equity,” said Steve Sell, chief executive officer, agilon health. “As the only full-risk program available in Traditional Medicare, we support the ACO REACH model and its role in sustaining local primary care by enabling primary care physicians to provide high-quality, cost-effective, holistic care for their senior patients.”

For the 2023 performance year, the average quality score for agilon’s eight REACH ACOs was 95%. In fact, four of these REACH ACOs attained a 100% quality score. In addition, five attained High Performers Pool status, achieving superior quality results across all four quality measures and yielding an additional $7 million bonus (not captured in the $150 million gross savings mentioned above).

“Through our long-term partnership with agilon health, we continue to see the impact of our participation in full-risk programs, including ACO REACH,” said Patrick Goggin, MD, vice president, Physicians Group of Southeastern Ohio (PGSEO), and ACO medical director. “Thanks to the shared savings generated from these programs, we’ve been able to reinvest in our practice, which has significantly improved the care experience for our senior patients, many of whom live in socioeconomically challenged areas. In fact, we’ve achieved more than $36 million in gross savings the past two years combined.”

In 2023, agilon’s REACH ACOs included 1,500 primary care physicians (PCPs) 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 $281 million in gross savings, including $71 million in savings to the Medicare Trust Fund.

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 ACO REACH model, call 1-800-MEDICARE (1-800-633-4227), TTY 877-486-2048. For questions about agilon’s Senior Connect ACOs, call 866-407-1660.

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 and health systems transition to a value-based Total Care Model for their senior patients. agilon provides the technology, people, capital, process and access to a peer network of 2,800+ 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 health care 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 about agilon health, visit www.agilonhealth.com and connect with us on LinkedIn, Instagram 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.