Capitation Payment Preparedness Program (CP3) Builds on Success

Improving the quality of and access to primary care holds promise for achieving improved health outcomes, increased utilization of the health system, and improved patient experience. In order to reach these goals, however, health centers need additional flexibility in their payment system to allow them to best care for patients and members. In essence, payment reform is a facilitator that reduces historical barriers to evidence-based change that can achieve the Triple Aim. CP3 works to ensure that health centers are optimally prepared to transform the way they deliver care and maintain financial stability through the transition from volume to value based care, while increasing alignment with the managed care system. CP3 has and continues to offer FQHCs the support, tools, and skills to manage the health of their patients while remaining financially robust. 

In order to evaluate the progress of the program, CP3 participants completed a pre and post readiness assessment. The comparison data collected demonstrates the full CPCA CP3 portfolio (including webinars, podcasts, and 12 in-person full-day trainings throughout the state) were instrumental in increasing readiness scores across most health center participants. Additionally, health centers that had in-person site visits by the CP3 team showed a marked improvement in the areas of Leadership and Learning Organization.  For example, one health center improved by 59 percent in Leadership and 83 percent in Learning Organization, while another improved by 26 percent in Leadership and 24 percent in Learning Organization.  The data from initial and one year post site assessments assists health centers in identifying growth opportunities and celebrating successes. It’s a great way for health centers to crate a narrative from statistical evidence and build a case to participate in different quality improvement and practice transformation initiatives. 

We believe that integrating practical, strategic, and relationship skill-building within the CP3 curriculum supports a community health center’s (CHC) ability to respond to and evolve within the changing environment.  In a state as diverse as California, a one-size-fits-all approach to delivering meaningful programmatic content is ineffective, so we made a concerted effort to engage CHCs to inform both the content and delivery methods for training and technical assistance (TA). A good example of this approach being successful is the combined in-person managed care trainings and on-site visits with CP3 centers. We believe the one-on-one support from CP3 staff and the willingness to see the unique operations of the health center first-hand made the TA approach more relevant and targeted, thus supporting a deeper relationship and collaboration among the health center team and CPCA staff.  

CPCA’s work initially focused on readying CP3 participants for their involvement in the Alternative Payment Methodology (APM) demonstration, but we quickly realized that opening up the managed care trainings to everyone allowed us to broaden our reach to add new sites to the program and to spread and share successes and lessons learned statewide. In doing so, we added five new sites to the preparedness initiative and are eager to add more sites in 2018.

CP3 has also focused on beginning and improving clinic relationships with health plans. We spent time early on in the development phase to work closely with health plan associations to develop standard criteria for being accepted into the pilot program. Additionally, we have spent time on a regional basis working with Consortia and health plans to understand the important role health plans hold in the pilot. 

The most significant outcome is the momentum among CP3 sites to move forward in developing practice transformation strategies. Peer learning, best practice sharing, and in-person trainings help to create a common sense of purpose and direction for health centers to recognize the collective movement towards practice transformation. CP3 has become a platform to foster and nurture leaders and advocates for practice transformation strategies that give first-hand insight to the solutions as well as the barriers that still need to be overcome to achieve a value based model of care.


The Capitation Payment Preparedness Program (CP3) is a technical assistance and training initiative developed to prepare Federally Qualified Health Centers (FQHCs) across California for delivery system transformation through payment reform. The primary objectives of the technical assistance program are to: 

Define what it means to be a successful FQHC within a value-based, managed care capitation payment system by identifying financial, operational, and clinical care delivery measures for health centers to work towards; 

Provide technical assistance (TA) and support to FQHC sites within the pilot, a value-based, managed care capitation system, so that they successfully transition from the current fee-for-service payment system to a new payment model; and 

Utilize the lessons learned within the pilot environment to inform future payment reform transition efforts of all California FQHCs.