The man at the table where Medicare math gets rewritten
Steven Sell took a job that almost nobody had ever held before: convincing independent primary care physicians, the same ones being absorbed by hospital systems for two decades, that they could go the other way - and take on full insurance risk for the sickest patients in America.
For five years, Sell ran agilon health. The company sits inside an industry built on visits, codes, and reimbursement schedules, and politely insists that none of it matters. What matters, agilon argues, is whether a 78-year-old with three chronic conditions stays out of the hospital for the next eighteen months. Pay the doctor for that. Stop paying for everything else.
Sell did not invent the value-based care idea. He simply got a national platform to bet the whole operation on it. agilon's business model is to partner with locally owned, physician-led groups, hand them the capital, the data, the analytics, and the contracts with Medicare Advantage payors - then let the doctors keep the upside if seniors stay healthier than the actuarial baseline. Long-term contracts. Twenty-plus years in some cases. A different clock.
He stepped down on August 4, 2025. The board installed co-founder Ronald A. Williams as Executive Chairman. The company withdrew its 2025 guidance the same day. None of that erases the fact that for half a decade, Sell was the person walking into doctors' offices in Ohio, Texas, North Carolina, and saying: we will pay you to keep them out of the hospital, and we will share the risk if it doesn't work.
The Pitch, In One Line
Pay primary care doctors for outcomes, not visits. Give them the platform. Take the risk together.
Why Anyone Listened
Because Sell had already run a $14 billion health plan with three million members. He had spent 22 years at Health Net. He knew the payor side of the equation better than the doctors did.
The net promoter scores from senior patients are 80-plus. Oftentimes in health care they're negative, or the best in class might be 20 to 40. That's better than Apple and Southwest Airlines.- Steven Sell, The CEO Magazine
Sell likes that NPS line. He uses versions of it across interviews. It is a useful tell about how he thinks: not as a clinician, not as a regulator, but as someone who treats the patient experience like a consumer metric and is not embarrassed to put it next to a tech company.
From Booz to a national platform
The path was not direct. Sell started as a consultant at Booz Allen Hamilton, the strategy firm that for a certain generation of executives was the equivalent of a finishing school. He moved into strategic and operational roles at The Prudential. Then he found Health Net, and stayed for the better part of a working life.
Twenty-two years at one company is a long time anywhere. In healthcare, where consolidation has been the rule and most leaders rotate through three or four logos in a decade, it is unusual. By 2016 he was running the place. From 2016 to 2019 he was CEO and President of Health Net, responsible for a business doing $14 billion in revenue and serving 3 million members.
Then, in 2020, he left for a smaller company most people had never heard of. agilon was a platform company in a category - value-based primary care - that public investors had not yet decided whether to love.
Career Timeline
What a $14B background does to you
Net Promoter, Sell's Comparison
The classroom behind the operator
Swarthmore is a small liberal arts school in Pennsylvania with a reputation for producing people who read the footnotes. Stanford GSB is the place where you learn to convert the footnotes into a P&L. Both show up in how Sell talks about the work: there is an analytical sentence followed, almost reliably, by a sentence about money.
Lines he keeps coming back to
On The Mission
"Everything we do is aimed at ensuring that, through our network, platform and partnerships, we are empowering primary care physicians to focus on value of care, and allowing them to spend time with their patients who need it most."
On Volume vs Value
"agilon health and its physician partners are creating the healthcare system we need - one built on the value of care, not the volume of fees."
On Why He Joined
"I was so struck by their ability to create a new primary care model, and one that could be applied all around the country."
On Complex Patients
"There was a tremendous opportunity to change health care delivery, especially for the most complex patients when the primary care physician is put in the driver's seat."
August 4, 2025
The leadership transition came in a single news cycle. agilon's board announced Sell's departure, named co-founder Ronald A. Williams Executive Chairman, established an Office of the Chairman, and withdrew the company's 2025 earnings guidance. AGL stock dropped sharply.
Anyone who has run a public company in healthcare knows the choreography. The press release is short. The conference call is shorter. The next operator inherits the model, the partners, the long-dated contracts, and the conversation about whether Medicare Advantage risk adjustment math still works at scale.
Things you only know if you ask
- He goes by Steve in interviews, Steven on SEC filings. Both work.
- Twenty-two years at one company is rare in healthcare leadership. Sell did it at Health Net.
- Before insurance, before the platform job, he was a strategy consultant. Booz Allen Hamilton. The classical apprenticeship.
- Lives and works out of Long Beach, California. agilon is headquartered in Westerville, Ohio.
- Took agilon public in 2021 on the NYSE under the ticker AGL.
- Prefers the Net Promoter Score framing for healthcare quality. Most executives don't.