2015 CAPP Annual Report


Integrated or organized systems of care will drive movement toward providing superior health care for patients, combining high quality and service with affordability.


CAPP promotes the superior performance of our physician-led medical groups and health systems in providing patient-centered medical care that maximizes the quality and  duration of life and enhances the health of our patients and entire community.


  • Integrated (or coordinated) care
  • Outcomes-based payment
  • Health information technology
  • Physician leadership
  • Quality measurement
A Message from the Chairman of the Board

The Council of Accountable Physician Practices (CAPP) comprises  28 of the nation’s most respected physician-led multispecialty medical groups.

Our members have long been exemplars for healthcare delivery. From their inception, each of these groups has embraced accountability for the quality and value of the healthcare services they deliver.

Although our physician-led groups vary in size, operate in different environments, and face different challenges, we all share fundamental beliefs:

We believe that the highest quality care can only be delivered by coordinating all the elements of care and service delivery and by using advanced information technologies. And we believe that the solutions to America’s healthcare problems will come from physicians who work with colleagues and patients to identify and implement innovative approaches — approaches that are both high tech and high touch.

I am pleased with the progress CAPP is making to insert the voices of medical group physicians into the current discussions around delivery system reform. I also look forward to showcasing our work in the years to come through the public forums we have developed.

To the CAPP medical groups, a heartfelt thank you for your ongoing support.

Dr. Robert Pearl
Chairman of the Board
The Council of Accountable Physician Practices

A Message from the Executive Director

Last year was pivotal for The Council of Accountable Physician Practices (CAPP). As this 2015 annual report describes, we moved our focus from “proving the case” of the value of organized systems of care to “stating the case.” This shift reflects a success we have achieved over the past decade. Now we hope to help others, including the media and the general public, understand the collective success of the multispecialty group model in providing high-quality health care.

With the support of our CAPP groups, our expert Advisory Council, and our policy partners, we have made significant inroads in elevating the physician voice in discussions about the way American health care should be organized to deliver better care to patients and achieve better health for the communities we serve. In addition, our research projects have contributed to understanding what consumers, physicians, and healthcare providers need and expect from the healthcare system.

We will be expanding on our 2015 work this upcoming year—telling more stories about how accountable care benefits both patients and doctors, and conducting more research on the changing nature of the healthcare world.

We hope you will join us on our journey as we strive to make American health care better by working together.

Laura Fegraus
Executive Director
The Council of Accountable Physician Practices

2015 Events

Advisory Council Annual Meeting

On June 3, 2015, the CAPP Advisory Council, a group of healthcare thought leaders, convened in Washington, DC to discuss how to better spearhead change in this era of American healthcare reform. To stimulate discussion, Advisory Council member Chip Heath, PhD presented his groundbreaking theory on “How to Change Things When Change Is Hard.”

Dr. Don Rebhun of Davita HealthCare Partners, Dr. Ira Nash of Northwell Health, and Dr. Robert Nesse of Mayo Health Systems then presented an overview of the challenges they face as they tackle the ever-present problem of incorporating contracted community physicians into their medical groups and organized systems of care. A panel discussion, “Expanding the Integrated Model: Notes from the Field,” followed, where the Council and the CAPP physician leaders shared their insights and opinions.

Better Together: High Tech and High Touch – Patient-Physician Relationships in the New Millennium

On November 4, 2015, the Council of Accountable Physician Practices (CAPP) and the Bipartisan Policy Center (BPC) partnered to host “Better Together: High Tech and High Touch—Patient-Physician Relationships in the New Millennium,” which was held at the Kaiser Permanente Center for Total Health (CTH) in Washington, D.C. This event was the first major public event that CAPP has sponsored.

Immediately preceding the event, a press conference was held to announce the results of a CAPP-sponsored Nielsen Strategic Health Perspectives consumer poll on consumer awareness of and interest in technologically-enabled care.  The specific communications and promotional activities for the survey and the event were developed to:

    • Raise awareness of the problems with healthcare delivery system fragmentation and the lack of clinical integration and accountability to highlight the need for sustained efforts around delivery system reform.
    • Secure interest from healthcare trade and mainstream consumer and business media.
    • Create a picture of what an ideal system could look like by featuring patient stories from four CAPP groups. These stories specifically showcased the power of coordinated care and 21st century technology.
    • Raise awareness and enhance the thought-leader reputations of CAPP, its leaders and its partners.

Poll results

“Do you have access to the following types of interactions with your primary doctor?”
All Forms of Provider Interaction Low; Tech‐enabled Communications Increasing Slowly

Phone call appointment reminders: 49%

A portal to log on and see your information: 28%

Online appointment scheduling: 21%

Postal mail appointment reminders: 10%

Email appointment reminders: 20%

Email correspondence about your health: 15%

Communication via online messaging platform: 15%

Text appointment reminders: 9%

Other type of correspondence or interaction: 3%

Panel discussions led by Janet Marchibroda of BPC, featured CAPP physician leaders Dr. Robert Pearl (The Permanente Medical Group), Dr. Brian Rank (Health Partners), Dr. William Conway (Henry Ford Health System), Dr. Steven Green (Sharp-Rees Stealy), and author and patient advocate David Goldhill.

More than 200 healthcare policy, media and industry representatives attended the conference in person and via webcast. The press conference and survey yielded more than 77 media stories (more than 1 million impressions), including major consumer stories from The Washington Post, U.S. News and World Report, Bloomberg, and the Huffington Post. Social media participation was tracked through the #BetterTogetherHealth hashtag.

For more information about the Better Together Health events, please visit bettertogetherhealth.org

Event Highlights

  • “The digital technology that many Americans use in often very busy lives—in banking, shopping, traveling, communicating—still plays but a bit role when it comes to their health care. According to a Nielsen survey released Tuesday, most people can't use email, texting and other tools to share medical information with their doctors, much less receive the same, because many providers don't offer such access.”

    Lena Sun
    Lena Sun The Washington Post
  • “This technology is easy to do. The hard part is changing the system, the payment and the regulations—which, by the way, were written in 1970s and ‘80s before iPhone existed, before Skype existed, before Google existed.”

    Dr. Robert Pearl
    Dr. Robert Pearl The Permanente Medical Group, host of the “Better Together” event
ranked the event “good,” “excellent,” or “very good.”
are likely to attend another Better Together event.
said that the information presented at the event was “useful,” “extremely useful,” or “very useful.”
rated the patient videos either “excellent” or “very good.”
felt positively about the event’s panel discussions.
said they learned something new at the event.
felt positively about the location of the venue.

2015 Media Results

The challenge of promoting care delivery models to consumers and media is constant. The fragmented nature of the system results in different care experiences for everyone and the tendency for competing healthcare organizations to use buzz words and jargon to market themselves creates ongoing confusion and misperceptions among patients. CAPP continues to refine and test our messaging about our core principles and about our models of care. We also strive to educate the general public and the media about the value of system-ness in health care.

In 2015, we employed several strategies to achieve these goals:

First, we combined the best of our accountable care websites (which were developed to educate the public about accountable versus traditional models of care) into a new home site for CAPP: accountablecaredoctors.org.

The new site includes a new whiteboard explainer video about what accountable care should look like, promotes American Medical Group Association (AMGA) member groups through a “Finding Accountable Care” link, and features commentary by CAPP and AMGA physician leaders through a new Accountable Docs blog.

CAPP's new Accountable Docs blog
CAPP's new Accountable Docs blog

The blog and the supporting social media activities (primarily through Twitter—@accountableDOCS—and CAPP’s YouTube channel featuring our videos), coupled with our search-engine marketing tactics, forms one major communications strategy to promote our work.  The other is the proactive media relations work we are undertaking with our new public relations form, Scott PR, to educate the media and strengthen our relations. The results for 2015 far exceeded our expectations:

New CAPP website


Whiteboard Explainer Video

Media Relations Results

Outreach to 100+ national and trade media to introduce CAPP as a resource for current and future stories
Top tier media placements
Healthcare trade media placements
Articles and blogs published on media websites
Total number of circulation/impressions: 67,919,485

In April, 2015, we attended the Association of Health Care Journalists’ annual conference for the first time. The conference is attended by healthcare journalists from across the nation who report for both trade and consumer media. Our objective was to introduce CAPP and CAPP members as media resources on delivery system reform and to better understand the topics that media were most interested in last year.

Healthcare Journalists Topic Survey

“Which of the following topics are you likely to cover this year?”

Accountable care organizations: 61%

Care coordination between doctors, specialists, hospitals: 45%

Create new healthcare roles to address the need for managing patients who need complex care: 55%

Healthcare payment reform from pay-for-volume to pay-for-value: 55%

Healthcare technology to improve access to care: 61%

Healthcare technology to improve quality of care: 48%

Overcoming the shortage of physicians and other healthcare professionals: 55%

Population health: 64%

Preventative health care: 73%

Price transparency in health care: 36%

Quality measurement of care outcomes: 36

Role of physicians in improving the healthcare delivery system: 52%

The Affordable Care Act: 64%

Use of evidence-based guidelines to deliver consistent care: 55%

2015 Research Projects

In addition to our communications activities, CAPP consistently pursues the goal of improving the high-quality, high-value health care our organizations provide through our research projects. In 2015, CAPP completed the following:

Physician Leadership Series

Based on the research conducted by CAPP in 2012, CAPP physician leaders authored a series of five articles to describe how leadership training occurs in their organizations, the structure of these programs, and lessons learned.

The first publication–a call to action entitled “Physician Leadership in Changing Times” (Cochran, Jack, Gary S. Kaplan and Robert E. Nesse) was published in  Healthcare: The Journal of Delivery Science and Innovation, 2014. The additional topics covered in the subsequent articles are:

  • Recruitment and Retention of Physician Leaders: Steve Tarnoff, MD, Group Health; Nick Wolter, MD, Billings Clinic; Linda Leckman, MD, Intermountain Medical Group
  • Training Physician Leaders: David Bronson, MD, Cleveland Clinic Regional Hospitals; Edward Ellison, MD, Southern California Permanente Medical Group
  • Physician Leadership in Organizations Undergoing Major Transformation: Lee Sacks, MD, Advocate Physician Partners; Robert Margolis, MD, HealthCare Partners, LLC
  • Physician Leadership at Small or Mid-Size Organizations; Joseph Bisordi, MD, Ochsner Health System; Marwan Abouljoud, MD, Henry Ford Medical Group

This series of five articles by CAPP physician leaders provides insights into how effective physician leadership was developed in different kinds of medical groups and will be published as a special online edition early 2016 in Healthcare: The Journal of Delivery Science and Innovation.

  • “Today, hospitals and physicians are reorganizing themselves in novel ways . . . These delivery system changes will take place with or without physician leadership. To optimize change on behalf of patients, physicians must play a conscious role in shaping future health care delivery organizations. As physician leaders of three of the nation’s largest integrated health care delivery systems – Kaiser Permanente, Virginia Mason Medical Center, and the Mayo Clinic Health System – we call on physicians to view leadership and the development of leaders as key aspects of their role as patient advocates.”

    Dr.Robert Nesse
    Dr.Robert Nesse Mayo Clinic Health System

Brandeis Capitation and Salary Study


This project is an ongoing collaboration between Brandeis researchers and CAPP to track payment reform progress and provide real-time analysis and consistent historical accounting of the “pay for value” movement.

  • Phase 1 results in 2012: The first study found fee-for-service to be the dominant payment method among the surveyed groups.  This research was published as “Many Large Medical Groups Will Need to Acquire New Skills and Tools to Be Ready for Payment Reform,” by Robert Mechanic and Darren E. Zinner, September, 2012, Health
  • Phase 2 in 2014: The survey was updated and expanded to include both CAPP and Group Practice Improvement Network (GPIN) groups.  The results, presented at the Health Industry Forum in Washington, D.C. on April 2, 2015, are awaiting publication.
  • Phase 3, to be conducted in upcoming months, will draw on the same sample and include 20 CAPP medical groups.

Physicians Foundation IDS/IPA Research

The Physicians Foundation sought to understand physician-led integrated delivery systems (IDS) and independent practice associations (IPA).  Specifically, the Foundation seeks to discover case examples of successful physician-led IDS/IPAs, including the steps followed in creating these organizations and lessons learned.  CAPP received a grant to conduct this research with Dr. Lawrence Casalino of Weil Cornell and CAPP Vice-Chair Dr. Norman Chenven, co-investigators and authors of the resulting paper.  The research has been completed.  The final report and publishable perspective paper is currently under review at Healthcare: Journal of Delivery Science and Innovation.


CAPP Board of Directors:

Robert Pearl, MD; CEO, The Permanente Medical Group and the MidAtlantic Permanente Medical Group


Norman Chenven, MD; The Austin Regional Clinic


Steven Green, MD; Sharp Rees-Stealy Medical Group


Ira Nash, MD; Northwell Health


Donald Fisher, PhD; The American Medical Group Association


Al Fisk, MD; The Everett Clinic


Robert Nesse, MD; The Mayo Health System


Philip Oravetz, MD; Ochsner Health System


Donald Rebhun, MD; Davida HealthCare Partners


Executive Director: Laura Fegraus


Communications: Toyomi Igus


Project Manager: Elizabeth Keating