Folks,

We recorded this interview in February – the dead of winter – and I have to admit that I needed some sunshine and positivity. Steve Sell supplied it with his enthusiasm, his can-do spirit and the fantastic advancements that agilon is making in allowing providers to practice primary care medicine with more time, more resources and more support while improving the care, care experience and outcomes for patients, and more specifically for Seniors.

Our guest this episode, Steve Sell, has served as the Chief Executive Officer and President of agilon health since June 2020. Prior to his current role, Steve served as President, CEO and Chairman of Health Net, Centene’s largest subsidiary, and has held a number of executive roles prior to that.  Steve received his B.A. from Swarthmore College and holds an MBA from the Stanford Graduate School of Business.

In this episode, we’ll hear about:

Friends – here’s the rub – the bottom line, so to speak. In the US, we spend way less than 10% of all healthcare expenditures on primary care – far less than most other developed nations. Despite the fact that decades of research demonstrate that the more primary care you have in a region, the better health outcomes you have and the lower costs you have. So, what we have is a perverse inversion of what we need from our healthcare system and in clinical care. The other perverse situation is that we’ve put primary care on a volume-driven, transactional payment and incentive model. The point of primary care is to prevent, and prevention takes time. It takes getting to know the individual and their family, the context of their life and their health habits, and then orchestrate care around their needs. It is a completely different value proposition than procedural care or even specialty care, and yet, we have ignored that and subjected both patients and providers to what many are now calling a ‘moral injury’.  

What I don’t understand is how healthcare leaders across the country, who must know this, are choosing to ignore it. What I also don’t understand is how CMS is not studying models like this, emulating them and spreading them. This is not a hypothetical model of care. This is a model of care that has been replicated in numerous regions with numerous stakeholders. It is a model that has been applied to lower income populations.  And most importantly, it is a model that has demonstrated improvements in patient experience and outcomes of care, as well as reductions in avoidable care and costs.  What are the leaders and experts waiting for??

And again, this is why I truly appreciate and applaud what agilon – and other similar companies – are doing. They are taking the high road by infusing primary care with the resources and support to make it what it should be for patients, and providers and their teams. They are making the transition to value-based payment rapidly – not a ten year, fifteen-year or never-year plan – but now.  

I won’t get into the specifics of how they’re doing all of this, but it’s all incredibly practical and all about the daily practice of medicine.  It’s all about where the rubber hits the road – removing the hundreds of daily roadblocks and incredibly frustrating, time-wasting hurdles that primary care providers are subjected to just to deliver good care. I would encourage you to listen to the podcast episode. It’s a truly elegant business model that removes the risk of transitioning from the primary care providers and allows them to practice medicine the way they know they should and the way they want to – the right way for their patients. It also allows primary care providers to do this while not suffering any loss in income. In fact, what surprised me is how much primary care providers can increase their income – which is frankly important if we are to have physicians, PA’s, and nurses go into primary care versus the much higher paying specialties. 

I’m truly interested in hearing your thoughts and questions about what agilon is doing.  Please post on LinkedIn or Twitter. This is a dialogue we must have in order to drive the much needed changes in American healthcare.

Until Next Time, Be Well.

Zeev Neuwirth, MD