A primary care-led, integrated palliative program scaled across multiple geographies, care sites, and payers demonstrated higher quality care while lowering total cost of care

Insert at end of the first paragraph of release issued November 16, 2023: The statements contained in this document are solely those of the authors and do not necessarily reflect the view or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

The updated release reads:

PEER-REVIEWED STUDY FINDS PALLIATIVE CARE PROGRAM UNDER AGILON HEALTH’S VALUE-BASED MODEL SIGNIFICANTLY IMPROVED PATIENT OUTCOMES

A primary care-led, integrated palliative program scaled across multiple geographies, care sites, and payers demonstrated higher quality care while lowering total cost of care

agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, announced the publication of new peer-reviewed data examining the impact of its full-risk, Total Care Model (agilon model) among both Medicare Advantage (MA) and ACO REACH patients enrolled in an innovative palliative care program. The first-of-its-kind study, published in the Journal of Pain and Symptom Management, evaluated a scaled primary care-led, integrated palliative care program across multiple geographies, care sites and payers. Results show the agilon model improved patient-centered outcomes for seniors with serious illness and kept them where they want to be: out of the hospital during the final months of life. The statements contained in this document are solely those of the authors and do not necessarily reflect the view or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

Under traditional fee-for-service models that predominate in the U.S., care for seriously ill patients largely fails to honor their wishes. While 90 percent of Medicare enrollees prefer to pass away at home, only 34 percent do, leading to unnecessary, potentially harmful care that burdens patients, their families and the overall health care system with unsustainable costs. The study showed that patients enrolled in a primary care-led, integrated palliative care program delivered within a full-risk model spent an average of five more days at home during their final months (133.5 versus 128.23; p<.001) and were almost two-thirds less likely to die in a hospital (9 percent versus 26 percent; p<.001).

“American health care is facing an impending crisis. We have a rapidly aging population and no specialized palliative workforce to care for this increasingly complex, vulnerable population,” said Benjamin Kornitzer, agilon Chief Medical Officer and a co-author of the study. “These new findings show the solution to this problem has been right in front of us all along: the primary care physician (PCP). With the support and resources provided by a full-risk model, PCPs are uniquely positioned to make a difference, leading the way with a scalable solution that has national implications for how we meet the needs of our sickest older adult patients.”

The study also found less use of acute care, including 39 percent fewer hospitalizations (p<.001), a 48 percent reduction in intensive care unit days (p=.0023), and a 21 percent reduction in emergency department visits for patients enrolled in value-based palliative care (p<.001). Ultimately, these drivers even impact costs for patients and their loved ones. Total cost of care from the time of enrollment until death was 33 percent lower for patients in a community-based palliative care program (p<.001).

“These findings underscore the ability of value-based care to drive better outcomes for individuals and their families,” said John Notaro, MD, Medical Director for Buffalo Medical Group and agilon physician partner whose practice participated in the study. “It is clear that there is tremendous benefit to patients and our health care system by investing in primary care physicians and helping scale palliative care programs.”

Click here to access the analysis in the Journal of Pain and Symptom Management.

About the Study

The study objective was to determine whether a multi-site, primary care-led, integrated palliative care program operating within a full-risk model improves clinical, utilization and economic outcomes. This retrospective observational study used administrative health plan claims data to evaluate outcomes for a cohort of Medicare beneficiaries who died between January 1, 2021 and January 31, 2023 and who enrolled in a palliative care program for at least 7 days. The analysis applied a propensity score matched methodology to identify an identical control (comparison) cohort of individuals to compare outcomes over time. Study outcomes included days at home, hospitalizations, intensive care unit (ICU) days, emergency department (ED) visits and total costs of care. The patients enrolled in the study were under the care of eight primary care practices who partner with agilon health and operate in a full-risk model. The study included 1,778 patients with 889 enrolled in the intervention arm and 889 matched cohorts both with an average age of 83.

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 2,400+ 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 visit www.agilonhealth.com and connect with us on X (previously known as Twitter), Instagram, LinkedIn and YouTube.

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