The American Medical Group Association has teamed up with Wilmington Health to establish a new value-based care peer learning network.
The AMGA Value Care Network, available to the association's members, will support organizations pursuing ACO excellence. The initiative will offer peer-peer learning opportunities, tools and frameworks to implement value-based care initiatives, leveraging the operational expertise of Wilmington as an enabler.
Wilmington, an independent practice with 300 providers, was the first to establish a commercial ACO in North Carolina, executives said. Today, more than 80% of its patients are in risk-based contracts across commercial, Medicare and Medicare Advantage. Given its experience, Wilmington has developed playbooks for implementing value-based care initiatives such as decreasing ED utilization or inpatient stays.
“Value isn’t what we do. Value is who we are,” Brian Voth, Wilmington’s chief development officer, told Fierce Healthcare. “What we’re trying to do is provide treatment to our patients, preventative in nature, so that we can control the cost of care throughout the entire healthcare continuum.”
The AMGA, a trade group representing medical groups and health systems, has long advocated for value-based care. The work, defined by the organization as delivering the right care at the right place and time, is also of interest to AMGA members, Jerry Penso, M.D., the AMGA’s president and CEO, told Fierce Healthcare.
“What they’re really looking for is, from their peers, solutions. In other words, who’s fixed a problem that they are facing, and how can they adapt that solution to their situation?” Penso said.
As part of the initiative, Wilmington will be ingesting data from participants, helping visualize and display the information in a centralized platform. While participants in the network will get to choose whether they share their performance data with peers, it will be strongly encouraged. Value-based care is most successful when the data are transparent and available: “We feel strongly that data aggregation will set us up for success,” Voth said. “We’re very focused on transparency and learning from each other.”
The deadline for the first cohort of organizations to sign up is in June. The network is targeting organizations that do not yet have mature value-based or population health management practices. “The easiest place for us to start is with those who want to start the journey and just don’t know how,” Voth said. Payers will set specific participation agreements.
As part of its advocacy work to federal agencies and Congress, the AMGA stresses the importance of ACO models being sustainable and predictable. “As members go along these journeys, they want to make sure that these programs are going to continue … that these programs aren’t changing dramatically year to year,” Penso said.
Like others, Wilmington, which participates in MSSP and ACO REACH, is waiting to see where the latter program is headed. Currently, ACO REACH is set to expire at the end of the 2026 fiscal year. Will a new program be introduced? Or will the Trump administration extend the deadline? “There’s a lot of groups out there asking what’s next,” Voth noted.
The AMGA is strongly aligned with the Trump administration’s focus on relaxing certain regulations that, in the organization’s view, impede the transition to value. One example is the SNF 3-day rule, which requires a patient to be hospitalized for three days before qualifying for nursing home care. This rule makes sense in a fee-for-service model, but not for value-based care, per Penso.
Regardless of the uncertainty, being prepared is worth it. “There will be value in medicine moving forward, in some way or another, and what we do today will set us up and prepare us for what comes down the pipe tomorrow,” Voth said.
“The certainty that we do have is that there’s waste in healthcare that needs to be reduced, there are outcomes in healthcare that need to be improved and we need to create an infrastructure that is sustainable and that can change with the changing requirements out there,” he added.