Employers and leaders of physician groups share a common goal: to achieve better health for their employees and patients while containing costs. Yet, employers and medical group leaders rarely communicate directly and work together to address common challenges. The goal of CAPP’s employer work is to better understand how the leaders of medical 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, a non-profit, purchaser-led organization with more than 12,000 public and private sector employers representing 45 million Americans.

With CAPP sponsorship, local coalitions convened their members and cohosted listening sessions facilitated by Public Values Research. CAPP conducted these focus groups in Chicago; Lehigh Valley, Penn.; Dallas–Fort Worth; Seattle; and Salisbury, N.C.

Early findings indicate that employers feel limited in their ability to modify benefit design and create custom provider networks due to a lack of transparency regarding cost and quality on the part of carriers and providers. Few are engaged in direct contracting or are testing entities such as accountable care organizations (ACOs) due to a lack of internal resources. Purchasers and their workers acutely feel the gaps in care delivery, the lack of up-front price information, and poor mental-health access.

The full results will be detailed in a public report this spring. Over the year, CAPP will advance this work through a series of webinars and regional roundtable discussions with employers and local physician group leaders.

The individual and collective voices of the CAPP medical groups continue to matter, as the pace to value-based payment is uneven. In 2019, CAPP explored the experiences and perspectives of the CAPP medical groups in an effort to stimulate greater innovation and the spread of value-based payment models. Interviews with 10 physician leaders and key stakeholders found clear trends in the transition to value-based payment, including:

• Medicare Advantage is an ideal model for most, but not all groups. Almost all support more incentives for beneficiaries to join Medicare Advantage. Several CAPP groups are doing both accountable care organizations (ACOs) and bundled payments, which can help engage specialists and drill down on costs.
• Most CAPP groups engage in some kind of value arrangement with employers, and all would like more value-based arrangements and direct engagement with local employers.
• Groups see their states beginning to promote value through Medicaid managed care and building all-payer claims databases.
• All of the systems are adopting interventions or partnerships around the social determinants of health and are enthusiastic about the promise of addressing these for their members and communities.
• Culture is a differentiating factor across CAPP groups. Many have a founder’s story that they build on, and they have maintained mission-driven cultures through leadership transitions.

CAPP leaders believe that the Centers for Medicare & Medicaid Services (CMS) must continue to lead and drive value-based payment forward. They look to the Center for Medicare & Medicaid Innovation (CMMI) to forge ahead in a leadership role, while listening to feedback from early adopters.

This year, CAPP supported board members who were featured at several major conferences, including:

World Health Care Congress: Norman H. Chenven, MD, founding CEO of Austin Regional Clinic, moderated a panel on accountable care and Medicare and participated in a video interview.

South by Southwest (SXSW): Ira S. Nash, MD, senior vice president of Northwell Health and executive director of Northwell Health Physician Partners, participated in the panel “Healthcare’s Digital Disruptors: Hope vs. Hype.”

Self-Insurance Institute of America, Inc.: Dr. Stephen Parodi, CAPP chair and associate executive director of The Permanente Medical Group, participated on a panel about the coordinated approach to cancer care for a self-insured employer audience. A CAPP-created video was screened showing the benefits of coordinated cancer care from the patient perspective.

National Alliance of Health Care Purchasers Annual Forum: Chelsea Pollet, director of direct-to-employer relationships for Henry Ford Health System, spoke on a panel about the health system’s contract with General Motors.

In 2019, CAPP had 316 total mentions (number of news items tracked). Media placements (excluding the impact of press releases) reached an audience of 780,580 unique visitors per month. Articles were placed in the following publications:

• MedCity News: “Telemedicine logistics: Network optimization using artificial intelligence,” included CAPP research, January 11
• Managed Healthcare Executive: “How to successfully transition to value-based care,” by Norman Chenven, MD, January 31
• Medical Economics: “A win-win approach to obtaining quality metrics and easing physician overload,” by Steven Green, MD, March 5
• HealthLeaders: “CMS primary cares: 5 steps to assess your readiness,” interview with Norman Chenven, MD, May 9
• Medical Economics: “Understanding the new CMS primary care payment models,” interview with Norman Chenven, MD, May 29
• HiTech/HealthIT Answers: “New generations, digital expectations,” cites CAPP telehealth research, August 14
• The Self-Insurer: “In search of health care’s holy grail,” interview with Stephen Parodi, MD, September 26
• Healthcare Finance: “Coordinated care model leads to decreases in unscheduled, preventable hospitalizations,” cites CAPP Nielsen research, October 9
• Physicians Practice: “How to screen for social determinants of health,” interview with Stephen Parodi, MD, December 5
• Managed Healthcare Executive: “Systems approach improving outcomes in hepatitis C,” interview with Stephen Parodi, MD, regarding CAPP groups’ hepatitis C programs, December 5

In May 2019, CAPP exhibited for the 5th time at the Association of Health Care Journalists annual conference to strengthen relationships with national and local health care reporters. CAPP administered an online survey and found that reporters continue to be interested in using CAPP as a news resource. The survey of journalists revealed their priority topics are mental health, social disparities in health care, and opioids.

CAPP coordinated media briefings with The New York Times for Dr. Parodi in May. In July, Dr. Parodi and Dan Slater, MD, of Atrius Health engaged in a media day in Washington, D.C., with the following outlets:

• CQ Roll Call
• MedPage Today
• Politico
• Bloomberg Industry Group (formerly Bloomberg BNA)
• Los Angeles Times

Social Media: Between January and December, CAPP’s Twitter account (@accountableDocs) reached an audience of more than 2,069 with content about CAPP groups, policy, and industry news, as well as CAPP-created content.