Steve Sell, Dr. Bill Wulf & Dr. Kevin Spencer: Preserving Primary Care Access for Medicare Patients

On September 22, 2021, Steve Sell, CEO of agilon health, joined Bill Wulf, MD, CEO of Central Ohio Primary Care and Chairman of America’s Physician Groups, and Kevin Spencer, MD, CEO of Premier Family Physicians, in a discussion at Global Health Care, LLC’s Value Based Payment Summit to share how primary care practices, through a partnership with agilon health, are embracing a global risk model to preserve access to independent primary care for Medicare beneficiaries and improve patient outcomes.
Preserving access to independent primary care for Medicare beneficiaries is critical for the health of our communities and for the sustainability of the Medicare trust fund, particularly as the nation ages and demand for primary care far outpaces the available physicians.
2020 was the first year in which less than half (49.1%) of patient care physicians worked in a private practice, a practice wholly owned by physicians. That marks a drop of almost 5 percentage points from 2018 and a drop of 11 percentage points since 2012. In 2020 - almost 40% of physicians worked directly for a hospital or practice at least part owned by a hospital or healthy system.
Numerous studies have highlighted that healthcare costs increase substantially in a community when physicians are employed by health systems.
The agilon health Total Care Model maintains the independence of physicians; unites them in a network of like-minded leaders; and integrates all the components of a global risk business model into a single platform.
Through a combination of global risk arrangements with Medicare Advantage plans and participation in the Global Direct Contracting model launched by CMMI/CMS in April 2021, independent physician practices across the US are sharing best practices and preserving their independence. These independent primary care and multispecialty practices, which range in size from almost 300 PCPs to 20 primary care providers, have partnered with 24 national and regional Medicare Advantage plans and CMMI to create a common experience for all their Medicare-covered patients, comprising 30-40% of their patient panels, as well as their front-line providers and staff members.
This standardization of process and concentration of mindshare allows them to support their practices in making the critical steps necessary to change care delivery to be successful in a global risk model.
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