Latest news with #IshaniGanguli
Business Wire
10 hours ago
- Health
- Business Wire
New Study Finds Senior Patients Managed by Women Physicians in a Value-Based Care (VBC) Model Have Equal or Better Clinical and Quality Outcomes and Less Healthcare Utilization
WESTERVILLE, Ohio--(BUSINESS WIRE)--agilon health (NYSE: AGL), the trusted partner empowering physicians to transform health care in our communities, today announced the publication of new peer-reviewed data examining the impact of gender differences of primary care physicians (PCPs) on patient outcomes, healthcare utilization and revenue using different Medicare payment models, specifically value-based care (VBC) and fee-for-service (FFS). Research was published in the May 16, 2025, issue of the JAMA Health Forum. In the study, researchers identified nearly 900 PCPs, of whom 40% were women, at 15 practice groups across seven states who deliver care through agilon's VBC model. Researchers then examined claims data from approximately 225,000 Medicare Advantage (MA) patients who were treated by these physicians, as well as the corresponding Stars quality data from national and regional payors. When comparing men and women PCPs in the same practice groups, researchers found that patients managed by women PCPs in a VBC model experience equal or better clinical and quality outcomes and less healthcare utilization, and the women physicians earned more per patient. 'The reversal of the gender gap under value-based payment implies that these models may be better aligned with desirable practice patterns that are more common in women, like spending more face-to-face time with patients in office visits,' said study author Ishani Ganguli, MD, MPH, Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Specifically, researchers observed the following: Outcomes: Senior patients managed by women PCPs experienced better key clinical outcomes, as evidenced by better hemoglobin A1C control and receipt of more eye exams for those with diabetes, compared to patients seen by men PCPs. Of note, similar patient outcomes were observed for blood pressure control and adherence to statin medication for cholesterol management between the two groups. In terms of quality scores, women PCPs had higher composite Stars quality scores, but lower provider rating scores than their men counterparts. Utilization: While the number of primary care visits were similar between the two groups, visits to the emergency room (ER) and hospitalizations were substantially lower for patients seeing women PCPs compared to those seeing men PCPs. Revenue: Compared to men PCPs in their own practice groups, women PCPs earned more per patient in the VBC model and similar amounts under the FFS model. 'As a woman physician, I believe VBC allows us the opportunity to leverage the relationships we develop with our patients, which correlates to improved outcomes, and the ability to be paid because of those important connections,' said study author Victoria DiGennaro, DO, Pioneer Physicians Network, Akron, OH. 'Our partnership with agilon health and implementation of its VBC model have been instrumental in enabling both of those to happen.' agilon's VBC model, which puts the physician at the center, is known as the Total Care Model. The Total Care Model takes the same physicians, the same patients and the same payors, and moves them from the challenges of FFS into a total care relationship, which results in high-quality care and improved patient clinical and quality outcomes, lower healthcare costs and healthier communities. It encompasses long-term partnerships, a purpose-built platform and a Physician Network that helps physicians overcome obstacles and transition to VBC. 'In addition to agilon's Physician Network, another benefit of our partnership has been the focus on women physicians, which includes a Women Physician Leadership Council,' added Dr. DiGennaro. 'Many women physicians want to practice medicine as they were trained, while finding that critical work-life balance, and I'm proud to be a voice for them through my involvement on the Council.' Study design In this cross-sectional study, researchers examined PCPs with primary care specialties who participated in agilon's Total Care Model. A total of 872 PCPs (352 of whom were women) working in 15 practice groups in seven states (Ohio, Texas, New York, Pennsylvania, Connecticut, North Carolina and Michigan) were included, along with 223,810 MA patients. Women and men PCPs had similar education, years of experience and specialties. There are several limitations to the study. First, results may not generalize beyond physicians who participate in risk arrangements. Second, MA patients represent only a portion of doctors' patient panels. And, finally, researchers cannot observe how individual practice groups translated MA payments to take-home wages (though comparing PCPs within the same practice groups mitigates this concern). 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 2,200+ primary care physicians that allow its physician partners 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 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 and connect with us on LinkedIn.
Politico
25-02-2025
- Health
- Politico
More telemedicine equals less spending
EXAM ROOM In the debate over whether to extend Medicare coverage for telehealth later this year, cost is king. A fresh data point to consider: New research suggests that when health systems incorporate telehealth into Medicare patient care, it leads to less spending. Dr. Ishani Ganguli, study co-author and associate professor of medicine at Harvard University, told Ruth that lawmakers are concerned telemedicine is driving excess Medicare spending and delivering worse care. The study's findings indicate that theory is likely not the case, Ganguli said. 'If anything, we're seeing some decreases in spending, and we're seeing less low-value care, which is a signal of higher quality care.' The results applied only to patients on traditional Medicare plans that reimburse for individual services and not Medicare Advantage plans, which operate under a different payment framework. Inside the study: Among 2.3 million Medicare beneficiaries in 286 health systems, the patients at health systems that frequently used telemedicine were less likely to be prescribed low-value tests and more likely to have lower-cost visits, according to the study, published in JAMA Internal Medicine. Those patients had slightly more doctors' visits than their counterparts in health systems that used telemedicine less often. Low-value tests were defined as yielding little benefit to the patient, such as offering prostate screenings to men over 70. While the screenings can detect a cancerous tumor, treating it isn't always the best course of action, especially for older patients, because treatment can significantly reduce quality of life — and it's often expensive. By the numbers: It's difficult to assess the cost savings associated with avoiding low-value tests and unnecessary treatments due to telemedicine, according to the researchers. Still, the authors estimated at least $66 million in savings on visit reimbursements because virtual visits tend to bill for less complex care. Why it matters: Lawmakers remain worried that telehealth will cost the Centers for Medicare and Medicaid Services big bucks. But research shows that telehealth can deliver better quality of care while also saving money. A study in Health Affairs last year found that patients at health systems that provide easy access to telemedicine were more likely to adhere to their medication regimens, received more continuous care from their doctors and visited the emergency room less often. The JAMA study builds on that work. What's next: Medicare coverage for telehealth services could become much more limited. Telehealth flexibilities first granted under the Covid public health emergency are set to expire on March 31. Congress has considered several different bills that would extend telehealth flexibilities for Medicare. The Congressional Budget Office estimated that a two-year extension of telehealth flexibilities would cost roughly $4 billion. WELCOME TO FUTURE PULSE This is where we explore the ideas and innovators shaping health care. The Department of Health and Human Services has taken down the AI Strategic Plan it released in January. The long-awaited document was part of an effort to lay a foundation at the department for better AI policy making. Do you work on AI at HHS? Reach out to Ruth. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@ Daniel Payne at dpayne@ Ruth Reader at rreader@ or Erin Schumaker at eschumaker@ Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. THE LAB Large language models like GPT-4 perform well on tests that involve reasoning — but the technology struggles when asked to answer variations of the same problem. New research published in the journal Transactions on Machine Learning Research tested humans against artificial intelligence-fueled GPT models on analogy problems, such as analyzing number or letter patterns, filling in missing letters or digits or understanding which of two stories corresponded to an example story. AI performed well on standard analogies — for example, cup is to coffee as soup is to X — but struggled with variations of simple analogies. Unlike humans, GPT-4 tended to select the first answer as correct more often than others, regardless of the right answer to the question. The technology also struggled when words in a story were reordered, which suggests it was seeking surface-level patterns in the material instead of engaging in deeper reasoning. Human performance remained consistently high when solving simple analogies and their variations. 'This suggests that AI models often reason less flexibly than humans and their reasoning is less about true abstract understanding and more about pattern matching,' Martha Lewis, research co-author and assistant professor at the Institute for Logic, Language and Computation at the University of Amsterdam, said in a statement. Even so: Humans and artificial intelligence models each struggled with problems that involved complex reasoning. What's next: Since AI is being experimented with and deployed in critical fields like health care, it's crucial that the systems be tested, the paper's authors wrote, not only for accuracy but also for how robust their analogical reasoning abilities are.
