Episode Details

In this timely episode, Dr. John Pagan welcomes Dr. Sanjay Doddamani to discuss two urgent and interconnected topics: the August 1st deadline for physicians to signal intent to join the PACN ACO for 2025, and the role that Guide Health — one of PACN's newest partners — is playing in helping independent practices manage complex Medicare patients and capture the full value of their quality care. This is a must-listen for any Pennsylvania physician considering ACO participation.

Key Highlights

About Guide Health Guide Health is a 25-year-old organization — expanded through a recent MSO acquisition — that specializes in making value-based care delivery more affordable and manageable for independent practices. Its model centers on medically trained health guides (medical assistants) supervised by registered nurses, who work remotely within a practice's existing workflows to support care gap closure, patient engagement, and documentation. Guide Health operates across four states and has been recognized as a best-in-class, number-one ranked provider of value-based managed services.

Dr. Doddamani brought a personal perspective to the work: having driven the length and breadth of Pennsylvania conducting home visits, he has seen firsthand how easily things slip through the cracks for complex Medicare patients — missed medications, repeated hospitalizations, unaddressed care gaps. Guide Health was built to close those gaps systematically and affordably.

How Guide Health Works With Practices Guide Health meets patients where they are — via text, voice, video, and direct connectivity to the practice — without creating new workflows or adding new burdens for the physician. Its technology platform aggregates clinical data from multiple sources: EHR records, claims, lab feeds, administrative data, and discharge summaries. Health guides have direct access to the medical record and are supported by nurses and care team members, ensuring that no patient slips through the cracks. The model is tiered: the sickest patients receive high-touch coordination, while lower-risk patients receive automated reminders and specialist connection support.

The PACN ACO: Why It Matters The PA Clinical Network ACO, active since 2022, allows independent practices to participate in Medicare Shared Savings — earning a share of the cost reductions generated by delivering better, more coordinated care. PACN is the only state medical society-sponsored clinical network and ACO of its kind in the country. With flat fee-for-service reimbursements continuing to decline, ACO participation represents one of the most meaningful opportunities for independent primary care physicians to be compensated fairly for the quality of care they already deliver.

The August 1st Deadline — Act Now CMS requires that any practice intending to participate in a Medicare ACO for 2025 submit a letter of intent by August 1st. Critically, this LOI is non-binding — it is simply a signal of interest that reserves a place at the table while both the practice and PACN evaluate fit. The final decision to join can be made several weeks later, into September. Any physician with interest — even preliminary — should reach out immediately.

What's at Stake: Hundreds of Moving Parts Dr. Doddamani outlined the complexity behind value-based care success: hundreds of individual tasks spanning quality gap closure, documentation, patient engagement, care coordination, and risk coding — all of which are nearly impossible for a busy independent practice to manage alone. Key opportunities include triple-weighted quality measures that significantly impact scoring, HCC documentation to ensure Medicare accurately reflects the complexity of each practice's patient population, and avoidable hospitalization reduction, which is one of the primary drivers of shared savings. Gui