Contract Administration Payment Solutions (CAPS)

CAPS is a proven and sustainable value-based payment model that helps restructure professional services agreements between hospitals and their affiliated physician organizations, including academic practice plans.

Using our proprietary technology, we develop and apply client-specific business rules, regulatory guidelines, and multiple payment methodologies to determine relative value and real costs of professional services. CAPS will help your organization achieve:

  • Hospital-Medical School Alignment
  • Accountability and Transparency
  • Positive Clinical Outcomes
  • Strategic Alignment
In addition to providing a market-based reimbursement model for clinical services, CAPS also provides a framework to restructure compensation for administrative services and on-call coverage that is supported by Fair Market Value analysis.

By adjudicating claims for professional services, we provide our clients with measurable and defensible data that focuses on performance, productivity, and value, and also informs physicians of the revenue derived from work performed at the hospital.

Through our detailed utilization reporting, productivity analysis, and benchmarking, our clients are able to substantiate payments to the physician organization, while enhancing physician productivity, retention, and recruitment, as well as improving patient outcomes.

 


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Realignment Strategies for Safety Net Hospitals and Affiliated Medical Schools
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“CAPS has provided the much
needed structure to make necessary changes to our payment model for professional services between Parkland and UT Southwestern Medical School. It has provided the desired transparency between the two entities. Since 2005, CAPS has allowed our organization to successfully and accurately adjudicate claims payment to the medical school of over $40 million a year.”
 
John Dragovits,
Executive Vice
President and CFO,
Parkland Health &
Hospital System
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