In addition to our hospitalist, intensivist and other inpatient solutions, ApolloMed contracts through our subsidiaries ApolloMed ACO and Maverick Medical Group to assume capitated and shared-risk to improve the care model and reduce inefficiencies. We have created physician-alignment strategies to assist hospitals and health plans gain access to best physicians in the market in a coordinated system that enhances patient and caregivers health care experience. We provide superior medical and business management services through an integrated network of hospitals and healthcare facilities, physicians and physician groups, payors and healthcare providers that achieve the triple aim: high-quality, efficient cost and satisfied patients.
ApolloMed business offerings and units include:
Independent Physician Association (IPA)
Maverick Medical Group (MMG) is a physician-led, equity partnership IPA, providing physicians the support to meet the challenges inherent in the operation of individual private practices. MMG operates under full and partial risk contracts with health plans, utilizing a network of primary care physicians and specialists. In our current California operations, we utilize a capitation model in which we contract with health plans to delegate either partial or full responsibility for member care to physicians and healthcare facilities that are part of our network. In return, we receive a fixed Per Member Per Month (PMPM) fee for each ApolloMed member patient. As a result, we have financial and clinical accountability for a population of members. Our focus is on senior and non-senior populations to capture members currently flowing to health plans, hospitals and other risk-bearing entities. We have contracted with Medicare Advantage, Special Needs, Commercial and Medi-Cal HMOs serving the Greater Los Angeles market. MMG affiliated Health Plans include Health Net, L.A. Care, Blue Shield, Central Health Plan, SCAN, Easy Choice. MMG is committed to delivering superior coordinated care and a positive patient-physician experience.
Accountable Care Organization (ACO)
ApolloMed was selected by the Centers for Medicare and Medicaid Services (CMS) to participate as an Accountable Care Organization (ACO) under the Affordable Care Act. ACOs are networks of physicians who work with hospitals and other key stakeholders to better manage quality and cost for Medicare fee-for-service patients. ApolloMed ACO is a Medicare Shared Savings Program provider that facilitates coordination and cooperation among healthcare providers to improve the quality of care for Medicare fee-for-service patients, while also reducing the cost of care. The cost savings are then shared between CMS and the ACO. We are leveraging our medical management expertise to more efficiently manage patient costs through improved care delivery with a focus on higher quality patient outcomes, lower utilization of hospital-based services and better care coordination with the primary care physician. We have exclusive contracts with more than 700 physicians and are providing population management and care coordination for 30,000 Medicare beneficiaries covering California, Mississippi and Ohio.
Hospice, Palliative Care, and Home Health
Apollo Palliative Services (APS) was founded in October 2014 to serve as a single source for hospice, palliative care and home health services for ApolloMed’s health plan, hospital and IPA clients in addition to its own subsidiaries and affiliated medical groups: ApolloMed ACO, Maverick Medical Group, AKM Medical Group, ApolloMed Care Clinics and ApolloMed Hospitalists. The hospice agency serves three counties in Southern California, with an average daily census of 40-60 patients, while the home health agency services three counties in California with an average daily census of 100-140.
The hospice division of APS serves terminally ill patients and their families through the use of an interdisciplinary team. Depending on their needs, each hospice patient and their family is assigned a team comprised of a physician, nurse, home health aide, medical social worker, chaplain, dietary counselor and bereavement coordinator. Hospice and palliative care services are provided in the patient’s home, assisted living/nursing home, or in a hospital. The home health division will provide direct home skilled nursing and therapy services, as well as specialty programs such as disease management education, nutrition and help with daily living activities.
ApolloMed believes that several factors will contribute to the growth of its hospice and home health business: aging demographics, recognition that in-home services are significantly more cost-effective than institutional care, medical and technological advances that allow more healthcare procedures and monitoring to be provided at home and the benefits of recuperating from an illness or receiving care for a chronic condition in one’s own home.
Currently, we provide Post-Acute Care services coverage at more than 50 skilled nursing facilities across Los Angeles that support our health plan partners and our own at-risk groups. Our goal is to improve the patient’s quality of life by improving the way that physicians interact. Our physician groups improve enhanced continuity of care with more frequent visits, medication reconciliation, and effective and ongoing communication with medical group case managers, hospitalists and primary care physicians.GNMA has proven to:
Reduce in-patient length of stay in hospitals
Lower the average re-admission rate
Allow more patients to pass peacefully in home/hospice environment
ApolloMed Care Clinics are focused on the efficient delivery of ambulatory treatment and ancillary services, with an increasing emphasis on preventive care and management of chronic conditions. Our clinics provide highly integrated comprehensive medical care for the entire family in anticipation of the on-going transformation of healthcare to value-based outcomes. Our clinics will also serve as post-discharge centers for patients who have just left the hospital.The Affordable Care Act incentivizes physicians based on quality metrics, and value over volume and encourages providers to treat patients outside of the hospital. This paradigm shift is moving care from its traditional delivery center, the hospital, to outpatient facilities. Additionally, the influx of newly insured individuals and the aging baby-boomer population will lead to more people requesting care. We have three clinics located within ApolloMed’s core service areas in Los Angeles. The clinics handle approximately 20,000 patient visits per year and provide adult primary care, cardiology care and pulmonary care, as well as lab and imaging services. We provide our physician partners access to our operational support infrastructure that utilizes highly advanced clinical applications and technology, and we conduct marketing and member relations services aimed at increasing patient flow.