Commitment Statement:

CAPG’s goal is for all CAPG members to have at least 90% of their Medicare (Original and Medicare Advantage) population in capitated payment arrangements by 2018.

CAPG and its members are committed to advancing alternative payment models that include the following defining features:
(1) prospective, capitated payment to a multispecialty physician group;
(2) physician group provides care for a defined population of patients;
(3) medical group assumes responsibility for medical care, quality, clinical performance measurement, and accountability for administrative and financial performance.
CAPG’s goal is for all CAPG members to have at least 90% of their Medicare (Original and Medicare Advantage) population in capitated payment arrangements by 2018.

More than 50% of CAPG’s members are already participating in the above model to the fullest extent possible for their organizations. Other CAPG members have some experience with capitated payment in Medicare Advantage and are pursuing other types of alternative payment models, such as accountable care organizations, with their Original Medicare populations.
CAPG is committed to supporting its members’ achievement of this goal through its educational and advocacy programs.

CAPG will continue to educate medical groups about best practices via the Standards of Excellence™ Survey — a blueprint for the development of the clinical and financial attributes necessary to be successful in capitated models.

CAPG will continue to build programming into our annual conferences, regular committee meetings, and Capitol Hill briefings that prepares physician groups to accept clinical and financial risk in the future.

CAPG will work with likeminded organizations in Washington, D.C. to advance the policies necessary to build capitated payment opportunities in Original Medicare.
CAPG will advocate protecting and strengthening capitated delivery models where they are flourishing today, including in the Medicare Advantage program.
CAPG will advocate improving and expanding existing alternative payment models to set a foundation for organizations that want to take capitation in the future.
CAPG will continue to advocate for new models that allow physician organizations to test capitated payments in Original Medicare. As an example, CAPG has developed the Third Option, a new delivery model that uses a capitated payment model to foster high quality coordinated care for seniors.




CAPG Guide to Alternative Payment Models

To achieve the goal of better care, smarter spending, and healthier people, the U.S. health care system must substantially reform its payment structure to incentivize quality, health outcomes, and value over volume. The Health Care Payment Learning and Action Network (LAN) was established as a collaborative network of public and private stakeholders, including health plans, providers, patients, employers, consumers, states, federal agencies, and other partners within the health care community.

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