Diabetes Patients See Significant Benefit from Value-Based, Total Care Model, According to New Data from agilon health

Medicare Advantage patients with diabetes in the agilon model saw 2-3 times greater improvement of Hemoglobin A1c control and other measures compared to Medicare Advantage and Medicare Fee-for-Service benchmarks

Patients with diabetes with consistent Hemoglobin A1c control achieved statistically lower costs

Benefits extend to Medically Underserved Areas

AUSTIN, Texas--(BUSINESS WIRE)-- agilon health, inc. (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, has released new data examining the impact of its full-risk, Total Care Model (agilon model) among Medicare Advantage (MA) patients with diabetes.

Overall, the analysis found that patients with diabetes cared for by agilon’s physician partners outperform all MA and Medicare Fee-for-Service (FFS) benchmarks, resulting in better health outcomes and a significant reduction in both out-of-pocket and systemwide costs for patients with consistently controlled diabetes. The analysis additionally found that these benefits extend to patients with diabetes who receive care within the agilon model and live in Medically Underserved Areas (MUAs).

“These data underscore agilon’s mission to create a healthcare system that works better for both primary care physicians and senior patients,” said Steve Sell, chief executive officer, agilon health. “By prioritizing quality of care over volume of services, agilon’s physician partners are meaningfully transforming the lives of their senior patients with diabetes, and by extension, their communities. We are committed to advancing health equity and are proud that these data show patients who live in Medically Underserved Areas are receiving the same, high-quality care as seniors in other areas.”

“One in four American seniors live with diabetes, which means that diabetes affects nearly every American family in some way,” said Benjamin Kornitzer, MD, chief medical & quality officer, agilon health. “Diabetes is a life-altering diagnosis for patients and causes significant financial and personal distress. Primary care providers in agilon’s Total Care Model are uniquely positioned to help patients avoid the debilitating complications of diabetes, including kidney failure, loss of vision, heart attacks, and strokes, among others. These data re-affirm that agilon’s physician partners provide best-in-class quality care based on CMS diabetes Star Rating measures and produced important cost savings for patients and the local healthcare system.”

agilon’s physician partners are accountable for the total quality and cost of care for nearly half a million seniors, including 112,000 patients diagnosed with diabetes. The data in the analysis examined care for patients with diabetes who met the Centers for Medicare & Medicaid Services’ (CMS) inclusion criteria in the Star Rating system for Hemoglobin A1c (HbA1c) control and eye exams in 2020 and 2021.

Over that time, HbA1c control among patients with diabetes in the agilon model increased from 81% to 88%. That increase was a 2.1 times better rate of improvement compared to all MA patients from 2020 to 2021, and 3.8 times greater than CMS’ multi-payor Comprehensive Primary Care Plus (CPC+) – considered the premier FFS model benchmark. In addition, the proportion of patients with diabetes in the agilon model who received an eye exam improved from 72% to 80%, 3.2 times higher than the improvement CMS reported among all MA patients during this period.

The analysis also found that the agilon model is effectively reducing the financial burden of diabetes care for both patients and the healthcare system. Patients in the agilon model with consistently controlled HbA1c levels in both 2020 and 2021 had 19% lower total cost of care than MA patients who could not demonstrate control in one or both years. Those savings translated directly to a 19% reduction in patients’ out-of-pocket costs. Additionally, patients in the agilon model with consistently controlled HbA1c had 47% fewer acute inpatient admissions, 65% fewer potentially avoidable admissions for any cause, and 84% fewer diabetes-related avoidable admissions than patients who did not have evidence of control in both years.

Moreover, these data show that agilon’s model is improving health equity for patients with diabetes. The analysis found that patients in the agilon model with diabetes who live in an MUA (28%) received the same, or better, quality of care compared to patients in the model in other geographic areas. Notably, patients in MUAs received 8% more annual primary care visits and 2% more annual wellness visits than those who live in other areas. Patients living in MUAs also had statistically identical HbA1c control as patients in other areas, as well as lower rates of admissions, avoidable admissions, and emergency department visits.

Click here to access the analysis in its entirety.

Additional Information:

• One in four seniors over the age of 65 have diabetes, with this number expected to grow as the U.S. population ages.
• Diabetes is the seventh leading cause of death in the United States.
• Adults with diabetes face a two-fold increased risk of heart attacks and strokes, and diabetes is the leading cause of kidney failure, lower limb amputations, and adult blindness.
• Care for people with diabetes accounts for one in four healthcare dollars in the United States, and people with diabetes have more than twice the average medical costs than people without diabetes.

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 2,200+ 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 25 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.

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Source: agilon health