63% Capitation Needed to Sustain Primary Care Transformation

RevCycle Intelligence September 6, 2017
Jacqueline Belliveau

A study indicates that high levels of capitation are needed to financially sustain team- and non-visit-based care in primary care practices.

A new study in Health Affairs found that 63 percent of primary care patients need to be under a capitation payment model to sufficiently fund the practice’s transformation to population health management, including team- and non-visit-based care.

Using a validated microsimulation model for over 40,000 primary care practices that collectively employed almost 241,000 full time-equivalent (FTE) physicians, researchers found that 95 percent of practices would gain revenue by shifting to team- and non-visit-based care as long as the practice was above 63 percent capitation.

In contrast, 95 percent of simulated practices would lose revenue if less than 23 percent...

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