2020 CAPP Annual Report

Our vision

Every person in the United States receives high-quality, affordable health care through a coordinated, value-based delivery system.

Our mission

Elevate the voice and experience of visionary physician leaders and their organizations to improve American health care through research, education, and communication.

About CAPP

A Message from the Chair of the Board

The COVID-19 pandemic year of 2020 was a challenging one for everyone — but it was especially hard for health care workers. Our care delivery system had to shift and change rapidly. Virtual care became the norm. Vaccine research was fast-tracked with such amazing results that today, little more than a year later, more than half of the population of the United States has received protection against the deadly coronavirus.

For those of us striving to improve American health care, watching clinicians, their medical groups, and hospitals take action was inspiring. If we can come together to ensure that Americans have access to care, treatment, and vaccination to meet this emergency, surely we can learn from the effort and continue to address the fissures in our health care system that have become very evident during these long pandemic months.

Despite the uncertainty that still lies ahead, the physician leaders of the Council of Accountable Physician Practices stand ready to work with all major stakeholders who can influence positive change in our health care system. We particularly welcome a continuation of the dialogue with employers that we started in 2020, a summary of which is provided in this Annual Report.

Many thanks to our CAPP medical groups and their leaders, who are at the forefront of the COVID-19 challenge and whose voices are so important as we work to reimagine American health care for the better.

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Stephen Parodi, MD
Chair of the Board
Council of Accountable Physician Practices

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A Message from the Executive Director

The Council of Accountable Physician Practices is dedicated to “stating the case” regarding the value of physician-led, clinically integrated, multispecialty medical-group practices and to promoting the collective success of our accountable care model in providing high-quality health care.

This year has been the most challenging for the American health care system since CAPP’s inception in 2001, but we were ready for the test. Our CAPP groups unleashed the power of our organized and coordinated care approaches to respond to the COVID-19 pandemic — protecting patients, saving lives, and guiding the nation through an unprecedented public health crisis.

Recognizing the stresses that our groups and physician leaders were under this year, CAPP pivoted to focus on a few key areas of work, while also judiciously engaging our physician leaders to provide guidance for the nation through media outreach, employer conversations, and COVID-19 commentary.

I’m pleased to share with you this report on CAPP’s 2020 activities.

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Laura H. Fegraus
Executive Director
Council of Accountable Physician Practices

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Communications Projects

COVID-19 blog series

To provide insights and learnings to our readers about medical group responses to COVID-19, CAPP published a blog series featuring efforts of the CAPP groups to combat the virus and innovate in their care delivery systems to improve patient care.

The following COVID-19 blogs were written and posted in 2020:

2020 CAPP board interviews: Learnings from COVID-19

In a meeting early in 2020, a board member suggested that CAPP collect insights and learnings from our leaders about how their health care systems responded to COVID-19 and use them to develop a physician-focused perspective on the future of American health care delivery. In response to this request, the following board members and CAPP physician leaders were interviewed:

  • Ira Nash, MD, Northwell Health Physician Partners
  • Alka Atal-Barrio, MD, The Everett Clinic
  • Norman Chenven, MD, Austin Regional Clinic
  • Jerry Penso, MD, AMGA (formerly American Medical Group Association)
  • Steven Green, MD, Sharp Rees-Stealy Medical Group
  • Philip Oravetz, MD, Ochsner Health
  • Wendolyn S. Gozansky, MD, and Abigail Miller, Colorado Permanente Medical Group
  • John Bulger, DO, Geisinger Health Plan

From those interviews, 6 recommendations for the future of health care delivery rose to the top. These were published on the CAPP website in “COVID-19 Lessons: A Path to a Better Health Care System” and promoted to the media via a news release sent on November 10, 2020. The news release and subsequent pitches garnered 9 media placements, featuring several CAPP board members.

Additional blog posts are being written to expand on and provide additional promotional opportunities for this piece.

The members of the CAPP Board who were interviewed (nine head shots)

Research

Employer listening sessions

Employers and physician group leaders share a common goal: to achieve better health for their employees and patients while containing costs. Yet employers and physician group leaders rarely communicate directly or work together to address common challenges.

In 2019 the CAPP board approved a multiyear, employer-focused strategy for the organization. The goal of CAPP’s employer work is to better understand how the leaders of physician groups can communicate and work with purchasers to improve health care outcomes.

To advance this work, CAPP partnered with the National Alliance of Healthcare Purchaser Coalitions (National Alliance), a nonprofit, purchaser-led organization with more than 12,000 public- and private-sector employers, representing 45 million American employees. With the assistance of local coalitions, CAPP embarked on a series of focus groups, or listening sessions, with employers from around the country.

Facilitated by our research partner, Public Values Research, CAPP conducted listening sessions in Chicago, Dallas, Seattle, and Bethlehem, Pennsylvania, in 2019, and completed the last listening session in Salisbury, North Carolina, in February 2020.

A summary of findings from the listening sessions is presented here:

CAPP and the National Alliance published a full report on the listening-session findings, “Better Together: Exploring Employer-Physician Collaborations to Deliver Quality Care.” The findings are being leveraged to further engage employers in roundtable discussions and conference presentations, and to inform additional research and discovery to improve physician-purchaser relationships.

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Investigating research gaps in accountable care

In October 2020, CAPP partnered with the Institute for Accountable Care (IAC) to convene a discussion among leading health services researchers, representatives of the Center for Medicare & Medicaid Innovation and the Medicare Payment Advisory Commission (MedPAC), and CAPP physician leaders. CAPP Chair Stephen Parodi, MD, CAPP Executive Director Laura Fegraus, and Atrius Health Chief Management Officer Joe Kimura, MD, joined a lively discussion of nearly 20 researchers, which revealed shared concerns and gaps in knowledge, as well as differences in perspectives.

Shared concerns included:

  • Mechanisms for driving behavior change and effective change management at the organization, team, and clinician levels are not well understood.
  • The wide array of payment models, lack of uniformity among them, and overlap of models creates complexity for providers and makes evaluation of the models more difficult.
  • For many organizations, the financial incentives in alternative payment models are not strong enough to offset the current incentives of fee-for-service payment.
  • Better access to commercial and Medicare Advantage data on alternative payment models would help researchers understand organization-level incentives and their impacts on performance.

Differences in perspective included:

  • Whether policymakers should prioritize getting more providers into value-based models, even if that means moving less aggressively toward 2-sided risk models.
  • Whether policymakers should encourage Medicare Advantage to advance the pace of value-based payment and shared-risk arrangements between plans and medical groups, instead of emphasizing Medicare and Medicare accountable care organization (ACO) models based on fee-for-service benchmarking.

Earlier in the year, CAPP asked Robert Mechanic, executive director of the IAC, to conduct a review of the literature on accountable care entities, programs, and payment models in order to better understand the factors that influence participation in accountable care arrangements and their performance on cost and quality outcome measures. The IAC and CAPP will publish this literature review—including recommendations for further research—and continue to use these collaborations and convenings to inform the accountable-care research and policy agenda.

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Events

Employer roundtables

Building on our learnings from the listening sessions, CAPP partnered with the National Alliance and some of its member coalitions — the Pacific, Midwest, and Dallas-Fort Worth Business Groups on Health — to conduct a series of 3 roundtables, which brought together employer purchasers and physician leaders. These roundtables focused on the following topics, which purchasing coalitions identified as priorities for joint discussion:

  • Behavioral health integration with primary care
  • Metrics for measuring performance in alternative payment models
  • Strategies for reducing low-value care and increasing high-value care

Originally planned to be in-person roundtables, the COVID-19 pandemic forced us to pivot to virtual settings. We found that the pre–COVID-19 topics remained priorities for purchasers, with added focus on the role that telehealth can play as well as the importance of addressing the health needs of more-vulnerable and at-risk employees and families.

Shared goals of purchasers and physicians:

  • Identify aligned interests.
  • Understand constraints and barriers that each party faces.
  • Discuss opportunities to contract, pay, and evaluate differently.
  • Describe and demonstrate care models that deliver better value and more-personal care.

Shared opportunities:

  • Assess the compatibility of benefit design with workforce health goals.
  • Leverage benefit design features to promote integrated care and a strong primary care foundation.
  • Reconfigure care models to incorporate telehealth and combine with value-based payment.
  • Explore joint research to inform messages and expectations for payers, employees, and other intermediaries.

We’re grateful to these business coalitions and their employer members, and the CAPP physician leaders, for participating in these roundtables during a challenging time. A full report on the discussions is forthcoming.

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Media Relations

Media Placements:

CAPP continues to work with Scott Public Relations as our media relations partner. Through its outreach efforts, Scott Public Relations elevates CAPP as the leading industry representatives in health care delivery reform, clinical integration, physician leadership, and accountability.

Overall CAPP Media Coverage

(Jan. – Dec. 2020)

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Total number of media mentions in 2020
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Media placements

Conference speaking engagements

Due to the COVID-19 pandemic, all conferences were either cancelled or shifted to virtual formats. Adapting to the changing schedules, CAPP was able to place our physician leaders in 3 high-profile conference events:

World Health Care Congress, “Strategies to Build a Robust Virtual Care Model and Respond to Today’s Heightened Demands,” with Courtney Stevens, Henry Ford Health System – July 9, 2020

Self-Insurance Institute of America (SIIA) Annual National Conference & Expo, October 12–15, 2020:

  • “The Role of Telehealth in Pandemics and Beyond,” Steven Green, MD, Sharp Rees-Stealy Medical Group
  • “What Employers Really Want: Results from a National Dialogue,” Norman Chenven, MD, Austin Regional Clinic
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CAPP Digital Channels

Website: In addition to the new COVID-19 blog series, the website’s Accountable Docs blog continues to feature commentary by CAPP physicians and to highlight case studies from CAPP groups. Additionally, CAPP leveraged its Better Together Health website to announce and showcase our employer work.

Social Media: CAPP’s social media strategy is focused on Twitter @accountableDocs. Our objectives are to:

  • Become a regular and trusted voice promoting value-based care and related topics, by engaging with other Twitter accounts and journalists.
  • Elevate value-based-care themes of CAPP member organizations, AMGA, and partners such as the regional and national employer coalitions.
  • Promote CAPP leaders’ speaking engagements, bylined articles, and other online content.
  • Drive traffic to new content on CAPP’s website.

A win for CAPP’s social strategy, for example, is to get engagement from Health Affairs, the American Journal of Managed Care, and other publications, which amplifies CAPP content on value-based care.

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Leadership

Board of Directors

Chair: 
Stephen Parodi, MD
The Permanente Federation and the Permanente Medical Group

Northern California

Vice-Chair:
Norman Chenven, MD
The Austin Regional Clinic

Greater Austin, Texas

Secretary:
Steven Green, MD
Sharp Rees-Stealy Medical Group

San Diego, California

Treasurer:
Ira Nash, MD
Northwell Health

Greater New York Area

Members:
Margaret Ferguson, MD
Colorado Permanente Medical Group

Western Colorado

Alka Atal-Barrio, MD
The Everett Clinic

Northwestern Washington State

Philip Oravetz, MD
Ochsner Health System

New Orleans, Louisiana

Jerry Penso, MD
AMGA (American Medical Group Foundation) Foundation

Alexandria, Virginia

Staff

Executive Director: Laura Fegraus

Communications: Toyomi Igus

Operations: Mary Cappabianca

Media Relations: Joy Scott

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