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:

• “CAPP Cites Six Key Findings from COVID-19 That Will Improve America’s Health Care System” (November 9, 2020)
• “COVID-19 Lessons: A Path to a Better Health Care System” (October 21, 2020)
• “CAPP Chair Stephen Parodi, MD, Tells FierceHealthcare that a Multipronged Strategy is Needed to Suppress Coronavirus” (June 18, 2020)
• “Returning to Routine Care as COVID-19 Cases Flatten” (June 17, 2020)
• “CAPP Supports Audio-only Doctor Visits During Pandemic” (June 8, 2020)
• “Integrated Primary Care Enabled Sharp Rees-Stealy to Pivot for Pandemic Needs” (May 28, 2020)
• “Expanding Telehealth for the COVID-19 World: An Interview with Courtney Stevens, Director of Virtual Care, Henry Ford Health System” (May 21, 2020)
• “Federal Flexibility for Care Delivery Innovation Should Outlast COVID-19 Emergency: The Case for Hospital-at-Home” (May 19, 2020)
• “Coping with the Financial Challenges of COVID-19: Federal Resources Available to Medical Groups” (May 18, 2020)
• “Incident Command: A Team of Teams Coming Together to Respond to COVID-19” (April 27, 2020)
• “Teamwork and Telehealth: Seattle Shows the Way in Early Pandemic Response” (April 16, 2020)
•  “The Value of Health Information Technology in a Time of Crisis” (March 26, 2020)

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.

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.

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.

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.

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.

• Medical Economics: “Screening for social determinants,” February 21, 2020 – Stephen Parodi, MD, The Permanente Medical Group
• Medpage Today: “With Ingenuity, We’ll Beat COVID-19 — Telemedicine and mobile treatment units will be invaluable,” March 30, 2020 – Stephen Parodi, MD, The Permanente Medical Group
• Medpage Today: “Docs Push CMS to Pay for Phone-Only Risk Adjustment Visits,” May 14, 2020 – Norman Chenven, MD, Austin Regional Clinic
• mHealth Intelligence: “CMS Expands COVID-19 Telehealth Reimbursement to Therapists, Phone Services,” May 1, 2020 – CAPP involvement with CMS decision
• Fierce Healthcare: “Physician groups concerned about financial shortfall for treating patients with complex health needs,” May 7, 2020 – Norman Chenven, MD, Austin Regional Clinic
• Healthcare Financial Management Association: “CMS issues reopening guidance to healthcare providers, patients,” June 12, 2020 –Smita Rouillard, MD, The Permanente Medical Group
• Passionate Pioneers: “Expert Coronavirus Updates – Session 13,” podcast, June 17, 2020 – Ira Nash, MD, Northwell Health Physician Partners
• American Journal of Managed Care: “How Can Healthcare Purchasers, Providers Better Coordinate to Improve Value-Based Care Delivery?,” MJH Life Sciences’ Medical World News podcast, July 31, 2020 – Norman Chenven, MD, Austin Regional Clinic
• Benefits Pro: “Consumers want more transparency, trust with health care providers,” August 3, 2020 — features CAPP report, “Better Together: Exploring Employer-Physician Collaborations to Deliver Quality Care”
• U.S. News & World Report: “There’s No Place Like Home,” September 2020 issue – Eliza “Pippa” Shulman, MD, Atrius Health
• Federal Telemedicine News: “CAPP Discusses Telehealth Innovations,” October 26, 2020 – Steven Green, MD, Sharp Rees-Stealy Medical Group
• Federal Telemedicine News: “CAPP Releases 6 Key Findings,” CAPP press release, November 23, 2020
• Medical Daily: “Meet the Oracles of Virtual Care,” September 30, 2020 – Courtney Stevens, Henry Ford Health System
• Medical Daily: “Lifting the Veil on Patient Records,” December 2, 2020 – Norman Chenven, MD, Austin Regional Clinic
• Modern Healthcare: “Employers and providers need a new dialogue to help fix healthcare,” October 30, 2020 – Laura Fegraus, CAPP
• Medical Home News: “Medical Group Trade Organization Says Primary Care Should be Boosted,” November 2020 – Alka Atal-Barrio, MD, The Everett Clinic; Laura Fegraus, CAPP; Norman Chenven, MD, Austin Regional Clinic
• Health Leaders Media: “Healthcare Leaders Reflect on 2020, Look Ahead to 2021,” December 23, 2020 – Stephen Parodi, MD, The Permanente Medical Group

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

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.