Primary Care Provider Capitation Proposal

Healthcare expenses continue to rise nationwide making health insurance coverage less affordable and reducing healthcare quality. Rising healthcare costs at QHS translates into less value for members via higher premiums for members, increased out of pocket costs for healthcare, and reduction in healthcare quality. A way to mitigate these negative impacts of increasing healthcare costs is to work together with willing healthcare providers to focus on increasing the overall health a population and encouraging correct, timely, and economically viable healthcare practices. Implementing a primary care capitation (PCP) reimbursement arrangement offers providers compensation through a fixed capitation arrangement. The arrangement includes provider incentives for ensuring members receive timely and essential care, encourages patient participation in preventative care and recommended vaccinations, and discourages unnecessary healthcare services. Focusing on prevention and routine primary care helps keep a specific population healthier, easier to manage, and require fewer healthcare services to care for them.

The capstone project was a fantastic way demonstrate the knowledge and skills I have gained during the HCA program in a real-world situation. I feel well prepared and ready to help my organization make meaningful, lasting improvements that will benefit both healthcare providers and patients. My organization was supportive of my learning and made my experience pleasant and worthwhile.