Specialist
Former VP at Privia Health Group Inc
Agenda
- Major trends and developments in the provider services market, highlighting Privia Health
- Value-based contract dynamics and efforts toward increasing value-based care arrangements
- Privia’s partnership with Navina – overall AI integration efforts and workflow enhancement opportunities
- Competitive positioning vs players such as Agilon (NYSE: AGL), noting key differentiations
- Network expansion opportunities and business growth outlook
Questions
1.
Could you comment on Privia Health's operating model and how this helps providers realise the benefits of a large-scale medical group while maintaining autonomy over practice operations at a localised level? How does this approach make the company a more compelling partner for providers?
2.
Could you elaborate on the specific initiatives or capabilities that Privia has employed to ostensibly bend the cost curve? Are there any strategies around specific services, administration or disease states that have been particularly effective?
3.
What's important for us to understand about Privia's 24/7 support and wraparound care team as it relates to getting accurate risk coding on its patient populations? How advanced are those capabilities, and what does this look like in practice as part of the broader cost reduction strategy?
4.
Regarding the tech stack, you mentioned the migration to the more singular structure. What's your assessment of Privia's current tech stack and wealth of patient data from the 4,000-plus-provider network? What initiatives do you think the company can pursue to better utilise the data assets to further reduce cost of care or realise better outcomes on the value-based arrangements?
5.
What are your thoughts on Privia's partnership with Navina, an AI-powered primary care platform, announced in September 2023? Perhaps we could frame the question around the broader value-add of AI and predictive analytics for Privia, but what capabilities do you think its tech brings to the table and how might this abet performance in the outcomes-based models?
6.
JP Morgan sell-side report estimated that around 70% or more of Privia's practice collections and over 60% of gap revenue are tied to fee-for-service models where the company does not assume risk. Additionally fewer than half of Privia's 403,000 government value-based care lives, which drive the overwhelming majority of VBC practice collections and gap revenue, are in two-way Medicare risk models as of Q1 2023. I know it's shifted slightly since then but could you talk about their appetite for
value-based contracts and how this might trend over time? How quickly do you think the company will assume more risk in these capitation arrangements, perhaps in light of some of your remarks around the tech assets and the benefits they're already seeing on those initiatives?
7.
What's your updated perspective on Privia's efforts to expand its health system partnership footprint? What qualities is the company looking for in these JVs – perhaps the health system practice size, patient population, its value-based care experience or other considerations if relevant?
8.
In terms of the newer partnerships for Privia, how do you think the unit economics and start-up costs of the health system JVs compare to the traditional independent physician groups? Do you anticipate any material difference in profitability in the Ohio and North Carolina markets?
9.
Privia's partnership with Novant Health seeks to steer 1,000 providers to Privia's network in order to achieve certain incentive bonuses, which is likely a multi-year initiative. Privia is guiding around 4,100 providers at the midpoint for 2023, which is an increase of 500 providers YoY overall. How realistic are some of the longer-term provider enrolment growth metrics, given what it's been able to achieve over the last 1-2 years?
10.
How are multiples trending for independent provider groups in the marketplace as we look to get a gauge on Privia's growth acquisition costs moving forwards in that demo?
11.
How competitive is the current market for qualified provider anchor partners with value-based care experience in key markets? In Q2 2023, Privia noted that implemented providers and overall lives came in slightly below consensus expectations. How much would you read into that in terms of potential saturation in the provider pool?
12.
What risk do you see from large Medicare Advantage payers such as Humana and UnitedHealth Group increasingly buying up provider groups? How might that reduce the total growth runway for companies such as Privia? You mentioned the evolving relationship of friendly and adversarial between Privia and the payers, so feel free to bring that in as well if relevant.
13.
How do you assess the relative prospects among provider-focused value-based care software partners such as Privia, Aledade and Agilon to win new contracts? They have different business models and strategies in terms of their contract dynamics and overall efforts to reduce costs. Which model or strategy do you think lends itself to better execution here and why? Who do providers prefer to work with?
14.
What are you monitoring on the regulatory front from CMS [Centers for Medicare & Medicaid Services] around potential changes to Medicare Shared Savings Program or ACO [Accountable Care Organization] Reach as it relates to value-based arrangements for physician groups and health systems?
15.
What's your reaction to the news that Shawn Morris retired as Privia's CEO in July 2023? He is being succeeded by Parth Mehrotra. Could you talk about the human capital loss for the company and what changes, if any, we might expect during the leadership transition?
16.
Privia brought on David Wichmann, former UnitedHealth CEO, along with Pamela Kimmet to its board in late July 2023. What do you think their oversight will bring to the table in terms of strategic direction or healthcare services expertise?
17.
Is there anything else that we have not touched on that might be especially important to highlight when thinking about Privia?
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