The senior care company agilon health (NYSE: AGL) has scaled a palliative care education model for its physician partners throughout most of the markets they serve.

agilon operates in 30 communities in 12 states. The company partners with primary care physicians across the country to jointly take on the total cost of care via Medicare Advantage or Accountable Care Organization (ACO) programs.

A 2023 study published in the Journal of Pain and Symptom Management found that the primary care-led, integrated approach to palliative care that agilon employs were two-thirds less likely to die in a hospital and on average spent five more days at home near the end of life.

Hospice News sat down with agilon’s CMO, Dr. Karthik Rao, to talk about the ways the company prepares physicians to provide palliative care to their most seriously ill patients.

How does agilon educate its physician partners about palliative care?

We do in-person, live training sessions once a partner decides to go live with palliative care, and those training sessions are really meant to accomplish three things. The first is to really understand that problem that we’re trying to solve for our patients through palliative care.

The second is identifying the right patients that are eligible for palliative care. When you go across the industry, there’s many different definitions of palliative care. We have one at agilon that we think best serves our patients, and so making sure that our providers understand that.

Third, I think just acknowledging that having even palliative enrollment conversations is challenging. A lot of the training focuses on just supporting providers to have effective and meaningful palliative enrollment and engagement conversations. It’s not something that’s typically taught in medical school or even residency for most folks. We do that through role playing when we have these training sessions.

Could you expound a little bit on your eligibility criteria?

So we don’t have strict [rules] that say you are in or cannot be in palliative care. We really define it by symptom burden, illness burden and risk of avoidable utilization. Ultimately, what we’re really trying to do for our palliative or high-risk population is ensure they have an extra layer of support to ensure their symptom burden is being treated effectively, and they have access to the care where and when they need it. Many of our palliative care programs offer in-home support and 24/7 access to care.

To what extent is this scaled across your footprint?

So right now, we have different flavors of palliative care across our 30-plus markets, but we are live in 20 plus of our markets today with palliative care.

Is this education done as a matter of course, or is it available upon request from the physician?

So we do it available upon request, in the market. We also have a provider learning website where we have a lot of materials and videos available on demand; that’s kind of that the adjunct to our in person sessions,

Who provides the training? Who are the instructors?

We have two or three national palliative care experts that we use as palliative care coaches and trainers across our markets. They’ve been phenomenal partners in working with us over the past few years, really helping providers understand what palliative care is and coaching them on effective conversations as well.

At what point might a physician involve a palliative care specialist to back them up?

That’s up to them. We have a palliative care eligibility algorithm that’s essentially identifying patients at high risk with severe illness, and we use that as purely just a tool for a set of patients a provider should think about. It’s a helpful reminder of who the sickest patients on a primary care provider’s panel are, and so they use that to at least remind or nudge a provider at the point of care to think about palliative care. But we leave the decision to refer to a palliative care program completely up to the provider.

At agilon, this has just been an amazing way to align what is investing in a program that really benefits patients that we wouldn’t have been able to do in a reactive fee-for-service world because we are in full risk.

I think about palliative care as being proactive and really engaging with our sickest patients before they have significant declines. I think it gives them a real opportunity to live what are honestly some of their most challenging days with the support they need and deserve. It really gives them an opportunity through that period to clearly define what that stretch of their care journey should look like. And so for us, it’s been an overwhelmingly positive experience to be able to invest in these programs.