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Cancer Survival Rates Improve with Health Care Delivery Innovations

Washington, D.C. (May 30, 2017) – Connected, coordinated systems of care are the key to saving lives and improving clinical outcomes for cancer patients, according to results presented at “All Systems Go! Closing the Gaps in Cancer Care,” the third annual Better Together Health event. Sponsored by the Council of Accountable Physician Practices (CAPP), a coalition of leading multispecialty medical groups, and the American Cancer Society (ACS), the event was held May 24 in Washington, D.C. at the Kaiser Permanente Center for Total Health. Representatives from CAPP, the ACS, the Biden Foundation, the Department of Health and Human Services, Centers for Disease Control and Prevention, Geisinger Health System, the Southern California Permanente Medical Group, and the Patient Advocate Foundation participated in the discussion.

“Americans face huge gaps in medical care, particularly when it comes to cancer,” said Robert Pearl, MD, chairman of CAPP, CEO of The Permanente Medical Group, and the president and CEO of the MidAtlantic Permanente Medical Group. “Across the country there are difficulties with access to care and preventive screenings. As a result, the likelihood of surviving cancer is lower than it needs to be. Outcomes vary by geography, economic status, race and ethnicity, and insured status. People die unnecessarily—not because we don’t know what to do, but as a result of the fragmentation of the current health care system, the absence of the most modern information technology, and frequent problems with access to care.

“We have the opportunity to change the system — to bring physicians together through integrated multi-specialty medical groups, link them electronically through comprehensive health records, and motivate them to provide all of the required preventive screenings. Through effective physician leadership we can structure care delivery to eliminate delays and avoid potential errors, help patients get treatment earlier, increase survival rates, and reduce disparities. The time for change is now.”

“This is a time of great promise in cancer care,” said Richard C. Wender, MD, chief cancer control officer of the American Cancer Society. “We have proven strategies for prevention and early detection, new therapies that hold tremendous potential, and more cancer survivors than ever before. But the fact is, when it comes to health, zip code matters more than genetic code. We cannot truly deliver on the promise we see until we eliminate health disparities within our communities. Working together we must ensure everyone has access to the navigation and coordinated care they need.”

The “Colon Cancer Moonshot” is an example of one successful initiative conducted by the Southern California Permanente Medical Group, which set a goal to reduce mortality from colon cancer by 50 percent in 10 years. By analyzing every phase of cancer screening and treatment process, and identifying and addressing those that impacted survivorship, mortality has been reduced by 17 percent in just three years. Screening rates for colon cancer, which were at 45 percent of patients (the national average) jumped to 90 percent. See the video of one patient’s story presented in the program here.

Another example from Geisinger Health System in Pennsylvania showed the impact of closely coordinated health care teams and patient centered care that helped avoid potentially dangerous complications and restore the health of a teenaged cancer patient. See the patient video here.

Additional panelists and speakers at the event included:

  • Jayne O’Donnell, Health Policy Reporter, USA Today, Moderator
  • Alan Balch, PhD, CEO, Patient Advocate Foundation
  • John Bulger, DO, Chief Medical Officer for Population Health, Geisinger Health System
  • John Fleming, MD, Deputy Assistant Secretary for Health Technology Reform, Office of the National Coordinator, U.S. Department of Health & Human Services
  • Michael Kanter, MD, Medical Director of Quality and Clinical Analysis, Southern California Permanente Medical Group
  • Laura Seeff, MD, Director of the Office of Health Systems Collaboration, Centers for Disease Control and Prevention

Health Care Crisis: Unsustainable Costs, Major Inconveniencies and Avoidable Deaths Mean Americans are “Mistreated”

Washington, D.C. (May 4, 2017) – Costs for health care in the U.S. are unsustainable, threatening the economic health of the nation, yet hundreds of thousands of Americans die each year unnecessarily because of a combination of medical errors, failures in prevention and health care disparities. The American health care system is broken; an inefficient care delivery structure, outdated technology, and profound misalignment of incentives result in millions of patients being mistreated.

This dire prognosis – and the treatment required to resuscitate American health care – is the message in the new book, Mistreated: Why We Think We are Getting Good Healthcare and Why We Are Usually Wrong, by Robert Pearl, M.D., chairman of the Council of Accountable Physician Practices (CAPP), a coalition of America’s high-performing medical groups and health systems, and CEO of The Permanente Medical Group, Kaiser Permanente.

Dr. Pearl’s warning and solutions were shared in two keynotes at the 14th Annual World Health Care Congress in Washington D.C., May 1 – 3.

“The real crisis today isn’t around how we structure coverage or even if it is paid through businesses or the government; it is the critical need to reform our entire health care delivery system,” said Dr. Pearl. “If we reward health care providers for value instead of volume, and leverage digital technology and video to connect the health care team and patients, we can actually deliver better quality care and a lower cost.”

“The medical groups in CAPP have demonstrated what is possible in terms of quality, convenience, technology, and cost, and how innovation improves patient outcomes. But if we as a nation do not embrace these changes more broadly, then we will experience either a huge disruption through global competition, or a slide into a two-tier system in which most Americans will get second-class health care.”

Mistreated: Why We Think We are Getting Good Healthcare and Why We Are Usually Wrong, released May 2, is dedicated to Dr. Pearl’s father who died due in part to medical error and failures in communication. In the book, Dr. Pearl explains how these medical errors can be eliminated through care coordination, technology and aligned incentives. Using psychological research, behavioral economics and the most recent brain scanning findings, he shows how our brains lead us to form incorrect perceptions about the health care we receive. He emphasizes the power of context, and how through integration, prepayment, information technology, and physician leadership, superior outcomes can be achieved.

Citing the unlikelihood of the legacy players in health care to make these types of sweeping changes, Dr. Pearl turns to patients to become a driving force for transformation.

“Mistreated” was written for the patient in all of us,” Dr. Pearl noted. “If we can change some of the erroneous beliefs we all have, we can make real change.”

Dr. Pearl is donating all profits from the book to increase access to health care for people who today can’t obtain it.

For more information, please visit his website:

To learn more about physician leadership in the work to achieve accountable care, and to receive updates on key health care issues, follow CAPP on Twitter at: @accountableDOCS.


CAPP Groups Receive Highest Quality Rankings from California’s Office of the Patient Advocate

Five of CAPP’s California-based medical groups achieved outstanding ratings from the state’s Office of the Patient Advocate in their recently released 2017 Medical Group report card for Medicare Advantage Plans.

The Permanente Medical Group, Palo Alto Medical Foundation, Southern California Permanente Medical Group, Sharp Rees-Stealy and HealthCarePartners Medical Group all received ratings of 4.5 stars or higher on a 5-star scale.

“The California OPA ratings are further evidence that CAPP’s multispecialty medical groups and health systems provide superior quality care compared to a majority of their peers in the marketplace,” said CAPP Executive Director Laura Fegraus. “Our groups draw on CAPP’s five pillars to offer patients coordinated, physician-led, technologically-enabled health care. The evidence speaks for itself.”

OPA’s Medicare Report Cards provide unbiased, precise ratings on 186 medical groups from 39 different counties in California. The report card serves as an online tool that allows users to search for medical groups by county or alphabetically and easily compare quality ratings side by side. It includes information on 13 separate clinical measures.

CAPP congratulates our member groups on their outstanding performance.


CAPP Urges Healthcare Reform Efforts to Maintain Focus on Quality and Safety Leading Medical Groups

Recommend Emphasis on Healthcare Delivery System Changes to Improve Care, Lower Overall Costs

As the “repeal or replace” debate over the structure of America’s healthcare system continues, the Council of Accountable Physician Practices (CAPP) urges decisionmakers to focus on healthcare delivery initiatives that are improving patient care, reducing medical errors and lowering the overall cost of healthcare.

“In the debate over healthcare reform, we must not ignore the importance of improving how healthcare services are organized and delivered,” noted Robert Pearl, M.D., Chairman of the Council of Accountable Physician Practices, a coalition of high-performing multi-specialty medical groups and health systems, as well as CEO of The Permanente Medical Group and president and CEO of the MidAtlantic Permanente Medical Group.

“If we do not continue to emphasize the need for care initiatives that promote physician-led, value-based, patient-centered, technologically-enabled care, we will lose ground in quality, innovation and outcomes that lower the cost of healthcare, while making it more available and convenient to patients. The consequences of inaction for our patients, their communities and the nation are significant.”

The foundation of healthcare delivery improvement rests on changes in payment incentives to providers, who instead of being paid fees for every service (the “fee-for-service” payment model), are now increasingly paid based on outcomes and performance. Innovations like electronic medical records and digital communications between healthcare teams, video visits with doctors, access to data to determine if patients are at risk, and improvements in preventive services are being adopted more rapidly to achieve better patient care and outcomes.

Pearl notes, “The CAPP medical groups are pioneers in linking physicians and patients with technology and digital communication, in delivering coordinated, connected care, and in forging patient/physician relationships that are both high touch and high tech. Physician leadership is behind all these improvements, ensuring that the welfare of the patient is first and foremost. When these enhancements are in place, patients get higher quality, faster care, medical errors are reduced, and better clinical decisions are made because information is available in real-time to all members of the team. “

CAPP physician leaders recommend:

  • Accelerated movement toward value-based payment for healthcare.
  • More widespread and coordinated use of health information technology so that care teams can access information related to patients’ health and treatment anywhere and anytime.
  • Simplification and standardization of quality measurement and reporting so that patients can identify healthcare providers with the best clinical outcomes.

These high performers can then help others to match their success and raise the national level of performance.


CAPP Chair Robert Pearl, MD, Discusses HIT in Hospitals & Health Networks (H&HN)

In this H&HN video interview, CAPP Chair Robert Pearl, MD, discusses a significant problem with new health care technology: HIT designers create the technology and then look at ways to apply it to healthcare. The better way to approach HIT development is to find the problem that needs to be solved and then figure out the technology that can help solve it, says Dr. Pearl, who is also executive director and CEO, The Permanente Medical Group; president and CEO, Mid-Atlantic Permanente Medical Group; and co-CEO, the Permanente Federation, LLC.

CAPP Leaders Discuss How They Develop Physician Leaders at Washington, DC, Colloquium

The Council of Accountable Physician Practices partnered with CAPG — a trade association that promotes accountable care — to host a panel at the CAPG Colloquium held in Washington DC, on September 29, 2016.

The panel, “Physician Leadership in the Movement Toward Accountable Care,” featured four CAPP medical group leaders who discussed best practices for recruiting, training and developing physician leaders.

The panelists represented a diverse range of medical groups in size, geography and model. The panelists were Dr. Marc Klau, Southern California Permanente Medical Group; Dr. Philip Oravetz, Ochsner Health System; Dr. Lee Sacks, Advocate Physician Partners; and Dr. Nick Wolter, The Billings Clinic. Dr. Robert Pearl, Chairman of CAPP and CEO of The Permanente Medical Group and the Mid-Atlantic Permanente Medical Group, served as the panel moderator.

“It will not be possible to move the country toward accountable, value-based care without strong physician leadership at all levels of the organization,” said Dr. Pearl. “Healthcare systems should view physician leadership as a capital investment for the future with huge ROI. The CAPP medical groups are committed to sharing their considerable experience to help all provider organizations face the challenges ahead.”

Development starts at recruitment
Over the course of the discussion, the panel touched on key aspects of their physician leadership development approaches. All agreed that leadership development starts at the moment of recruitment into the organization. “Every physician is a leader. We start with that assumption,” said Dr. Klau. “Take every physician on as a leader and then expand their capability, because you never know when you will need them.“

Dr. XX speaking at the CAPG colloquium.
CAPG CEO Don Crane introduces the CAPP leaders and the importance of physician leadership to move the needle on accountable care.


Each of the medical groups has their own leadership training programs that have evolved over the years. Ochsner Health System, for example, has several tiers of leadership training that are designed to match physicians with their age and career experience. “We believe every physician is a leader by definition, but some exhibit their ability to lead more than others, or earlier in their career,” said Dr. Oravetz. “Our program exposes these folks to what a management career might look like.”

Regardless of the specifics of the training and development programs, the panelists overwhelmingly agreed that two critical traits for physician leaders are emotional intelligence and proven clinical excellence. “The best leaders are going to be visionary but anchored in reality,” said Dr. Klau.

“Self awareness is important to put on the table. What’s your humility? How do you develop people to create trust that’s necessary for good teamwork?” said Dr. Wolter.

Physician leadership as a strategy
Dr. Wolter stressed that physician leadership development should be considered outside of health care system payment as a strategy to improve care quality and patient outcomes. “No matter how the payment system evolves, if you leverage team care and leadership, that’s going to lead to better outcomes.”

Dr. Sacks agreed, saying that his group places leadership development at a premium. “It’s about improving care. The finances will follow,” he said. “Focus on what really resonates, which is improving outcomes.”

Following the discussion, the CAPG audience posed questions to the panel about the how-to’s of physician leadership development. The panelists agreed that physicians who aspire to lead their health system should start small. They mentioned that emerging physician leaders could join clinical improvement committees or attend the first stage of a leadership program as ways to determine if the track is right for them.

The panel was comprised of four of the 11 medical groups that contributed their case studies to CAPP’s five-part journal series about physician leadership development, which was published in the journal Healthcare: Delivery Science Innovation. The articles can be read in full here.

Medical group leaders gathered to discuss physician leadership at the recent CAPG Colloquium.
CAPP medical group leaders gathered to discuss physician leadership at the recent CAPG Colloquium.


Photos courtesy of Thomas Van Veen of Documentary Associates

CAPP Health Care Primer: What Candidates Need to Know

By Robert Pearl, MD, Chair, Council of Accountable Physician Practices

With thousands of political offices up for election this November, health care will continue to be a complex and frequently debated issue.  To help focus discussions, the Council of Accountable Physician Practices has produced an original primer, “What Every Candidate Should Know About Health Care.” This primer is for candidates running for local and national elected office and details the most critical health reform topics they must understand to ultimately improve the medical care their constituents receive.

The three primary issues highlighted in “What Every Candidate Should Know About Health Care” are:

  1. Payment system reform to enable acceleration of the move towards value-based payment and away from the current volume-based fee-for-service model, aligning incentives to reward better patient outcomes, safety and efficiency.
  2. Expanded use of health information technology so care providers always have the information they need to make the best care decisions.
  3. Consistent and meaningful quality measurements to accurately identify high-performing medical groups and health systems.

By bringing these healthcare issues into the political discourse, the leaders of CAPP believe they can educate and inform elected politicians on the accountable approaches that produce the highest quality and best health outcomes for patients.

We encourage you to read and share “What Every Candidate Should Know About Health Care”  and send us feedback on twitter @accountableDOCS.


New Brandeis Study: Medical Groups That Take On Risk Show Success in Quality, Care Management

The American Journal of Managed Care recently published a second round of research sponsored by the Council of Accountable Physician Practices (CAPP) on the prevalence and magnitude of capitation and other alternative payment contracts among CAPP’s organized physician groups.

“Risk Contracting and Operational Capabilities in Large Medical Groups During National Healthcare Reform” represents CAPP’s ongoing commitment to promoting the benefits of outcomes-based payments, one of our five pillars.

CAPP partnered with Brandeis researchers Robert Mechanic and Darren Zinner in 2011 to launch a longitudinal study. The focus of the research is to gauge the incidence of alternative payment contracts among CAPP groups, understand these groups’ previous experience with managing risk, and to define the approaches to physician compensation utilized by these groups. This published report is the second round of research conducted.

“This is one of the only published analyses examining payment and contracting practices for a variety of organizations across the full range of their payers. This allows us to better assess the relationship between contracting structures and organizational practices likely to positively impact performance” said Mechanic.

Twenty-two CAPP groups have participated in the survey’s second round, as well as 11 member groups of the Group Practice Improvement Network. The survey asked for information about quality and cost management programs, risk contracting, physician compensation changes and other factors to evaluate risk-based payment models.

According to survey findings, medical groups that received a high portion of revenue from risk contracts were able to more successfully implement advanced programs to avoid hospitalizations and provide care management. It also found that these groups placed greater emphasis on quality and patient experience in their physician compensation models and relatively less on the amount of care provided.

“Groups that had a higher proportion of risk contracts generally had physician compensation models with more emphasis on quality, patient experience and performance, compared to groups in fee-for-service models,” said Mechanic.

He predicted that future rounds of this survey would show a slow and steady movement toward alternative payment models. “Taking on risk is not easy or straightforward, so you really have to have an organization that believes in managing care and physicians that buy into the culture,” he said.

“The Brandeis findings are clear evidence that risk-based payment models allow physicians and medical groups to focus on the patient and their needs, not just on a bottom line,” said Laura Fegraus, Executive Director of CAPP. “CAPP is excited to be a part of this ongoing project to track payment reform progress and provide both current analysis and consistent historical accounting of the “pay-for-value movement.”

A third round of this survey is currently in the field. Results are expected in early 2017.

Read the entire journal article here.

“Better Together Health” Wins Healthcare Campaign of the Year Award

“Better Together Health: High Tech and High Touch – The Patient-Physician Relationship in the New Millennium,” the first of the annual campaigns sponsored by the Council of Accountable Physician Practices, has won the PR World Award with its public relations partner, Scott Public Relations. The campaign, designed to raise awareness of the effectiveness of multispecialty medical groups and systems of care in improving care quality and cost, was honored for its effective promotion and media relations work. View the highlights of this event here.


Improving Care for Chronic Illness

Experts, Patient Advocates at “Better Together Health” Recommend Payment Reform, Digital Technology, and Standard Quality Measures; Keynote Sen. Johnny Isakson Calls for Focus on Wellness and Disease Prevention

Washington, D.C. (July 5, 2016) – With a new Nielsen Strategic Health Perspectives study showing that people with chronic illnesses get only slightly more care coordination than other patients, participants at the “Better Together Health: Patient Expectations and the Accountability Gap” that convened on June 15 shared solutions for improving care and patient outcomes.

The event was sponsored by the Council of Accountable Physician Practices (CAPP), a coalition of leading integrated multi-specialty medical groups and health systems across the United States and the Bipartisan Policy Center.

”Today, half of Americans live with a chronic condition,” said Robert Pearl, M.D., Chairman of CAPP, and CEO of The Permanente Medical Group and the Mid-Atlantic Permanente Medical Group. “The challenges for American health care are to prevent chronic illnesses in the first place, intervene early to avoid complications and use 21st century technology to support patients throughout their lives. Multi-specialty medical groups with strong physician leadership can accomplish each of these better than the rest of the nation, and the beneficiaries are their patients.”

Panelists discussed results from the Nielsen survey of over 30,000 American consumers and over 600 physicians that revealed only about half of Americans reported receiving patient care from coordinated care teams and about one third have 24/7 access to care other than through the emergency room.

Policy improvements suggested to support the continued development of an effective integrated healthcare delivery system include improved EMR interoperability, a movement toward paying for value and modernized, patient-focused quality measures.

Event keynote speaker Sen. Johnny Isakson, (R-GA), co-chair of the Senate Finance Committee Chronic Care Work Group, reiterated the group’s commitment to helping Medicare patients with chronic illnesses receive the care coordination they need. “We must ensure that wellness and disease prevention are top priorities for the next Administration,” Isakson said.

Tim Gronninger, Deputy Chief of Staff at the Centers for Medicare and Medicaid Services, spoke about new legislation designed to bring about payment incentives to help support the adoption of integrated care. Other panelists included:

  • Ceci Connolly, moderator, President/CEO, Alliance of Community Health Plans
  • Karen Cabell, DO, Chief of Quality and Patient Safety, Billings Clinic
  • Regina Holliday, Patient Rights Activist, Artist and Author
  • Marc Klau, MD, Assistant Regional Medical Director, Southern California Permanente Medical Group
  • Leana Wen, MD, Baltimore City Health Commissioner