Blended Capitation Model
Is Fee For Service restricting your efforts to deliver care in the way you want to practice?
If you answered "yes", then you and your clinic colleagues may want to consider the Blended Capitation Model (BCM).
The Blended Capitation Model (BCM) is an alternative to traditional fee-for-service (FFS) compensation, blending patient-based capitation payments and volume-based payments through FFS.
BCM is a demonstration project supported in partnership by ACTT and Alberta Health. Learn more about other Clinical Alternative Relationship Plans.
The goal of the BCM is advancement of the Patient’s Medical Home and delivering a quality care experience to patients through improved access, continuity and comprehensive team-based care:
✓ Continuity where relationships matter✓ Care coordination and delivery by an interdisciplinary team✓ Good access to care and a patient centered approach✓ The ability to deliver care in innovative ways✓ Professional autonomy, satisfaction✓ Happier, healthier patients✓ Predictable income stream for easier budgeting and stability
What are your colleagues saying about it?
What is the most valuable part for physicians implementing the model?
"The physicians really encourage us as LPNs (Licenced Practical Nurses) to maximize our skill set and our practice."
- Tanis Bergen, LPN Sylvan Family Health Centre
Should I join the Blended Capitation Model?
Any office-based comprehensive primary care clinic with a desire to advance the Patient’s Medical Home is eligible for the BCM demonstration project. Clinics that are successful with the Blended Capitation Model:
- know their panel
- have good access or taking steps to improve access
- have a quality improvement (QI) team in place and meeting regularly
- meet regularly with the physician group
- work together collaboratively, as a team
- share a philosophy of careFind answers to Frequently Asked Questions.Watch to learn more about the Sylvan Family Health Centre BCM experience.Video source credit: Rural Health Professions Action Plan
How to enroll1. Initial ContactClinics seeking more information, or that are interested in joining the model, are invited to contact the BCM implementation team to express their interest in participating.2. OrientationThe BCM implementation team is happy to meet with your clinic to share more about the Blended Capitation Model, answer questions, and explore if it is right for you.3. Financial ModellingAs part of the decision-making process before joining the BCM, clinics will be provided with the opportunity to participate in financial modelling to simulate BCM payments and negation based on a clinic’s previous three years of billing. The financial modelling will help the clinic to understand how total compensation on BCM compares to fee for service. This modelling gives clinics an idea of their future compensation levels.4. ApplicationA formal application submission is required as your participation in the Blended Capitation Model is through a Ministerial Order with Alberta Health.5. ImplementationYou will receive support from your BCM implementation team to operationalize the model including support for process redesign (administrative and clinical) as well as access and training around reports related to BCM. You will have an opportunity to be part of the BCM community of practice.
SupportACTT, AMA Health Economics and Alberta Health provide supports to clinics implementing BCM in the following areas:
- Financial modelling
- Process redesign
- Clinical and administrative
- Continuity and access
- Team-based care and alternative delivery modes
- Process/policy mapping
- Change management and team development
- Practice agreements
- ACTT can facilitate sessions with all physicians to draft a new Practice Agreement
- Including models of financial distribution at the clinic level
- A Community of Practice you can join upon proceeding with the model to share ideas and learn from other BCM clinics
- Billing queries and billing requirements
- Reporting and payments
- Navigating Alberta Health forms