Risk and Capitation During a Pandemic

Presented on:
July 21, 2020 9:00 AM PT
1 hour

The COVID-19 pandemic, associated economic impacts, and resulting complicated federal stimulus and relief efforts have created an unprecedented operating environment for US health care entities. In addition to financial, operational, and provider morale demands and obstacles, health care entities face economic uncertainty.

As the health care industry is forced into a cry for unparalleled evolution and reform, entrepreneurial providers who have committed to, and invested in, risk-sharing models have been emerging relatively strong during this crisis. Providers that have adopted risk-based strategies have notably stratified their risk and are successfully managing population health and care delivery. If ever there were a perfect real-world scenario to test risk-driven models of health care reform, COVID-19 has presented it.

Join us for an on-demand webcast panel discussion featuring successful leaders from the battlefield reporting firsthand how a risk-based strategy is proving to be the preferred health care paradigm in a complicated health care system. We are pleased to moderate a panel with guest speakers and Karl Rebay, Health Care Consulting Partner at Moss Adams will moderate a discussion with these leaders on the forefront of health care payment reform.

Topics we’ll address:

  • Observations front the frontlines on managing risk during a global health crisis
  • How risk-based organizations have proven to be nimble and strong enough financially to survive a global pandemic
  • How risk-based organizations are structured to pivot and leverage change to the patient’s benefit
  • How capitated payment structures have benefitted providers during the COVID-19 pandemic


Donald Crane, Attorney (Esquire), President and CEO, America’s Physician Groups

Don Crane leads the nation’s largest trade association that explicitly promotes capitation as the payment model for its members, all of whom accept various forms of risk-based capitation or other population-based payment. A seasoned health care attorney, Mr. Crane has served as corporate counsel for several major integrated health systems. Mr. Crane speaks regularly on health care issues to a wide variety of physician groups, hospitals, and other professional meetings.

Melanie Matthews, MS, Chief Executive Officer, Physicians of Southwest Washington; President, Multicare Connected Care

Melanie Matthews is the dynamic, creative, and innovative CEO at Physicians of Southwest Washington (PSW) and Melanie Matthews brings more than 20 years of operations, financial, human resources and product marketing experience in health care services for specialty populations. Since joining PSW in 2016, she has maintained the core principals in which PSW was founded on and expanded business lines to include MSO services including credentialing, coding and compliance and the implementation of CMMI innovation models such as the Next Generation ACO. Melanie’s extensive knowledge in post-acute care provides strategic focus in reducing overall cost of care as well as provider and beneficiary engagement.

Ray Chicoine, MBA, President & Chief Executive Officer, Monarch Healthcare

Ray Chicoine is President of Monarch HealthCare, an IPA model medical group which was founded in 1994. Monarch is comprised of over 2,000 physicians providing coordinated care to 250,000 Commercial, Senior and Medi-Cal patients throughout Southern California. Monarch was designated a 2012 Pioneer ACO and continues to participate in a number of commercial ACOs. Prior to Monarch, Ray served as the Orange County Regional Vice President for MedPartners, a publicly traded Physician Practice Management Company. While there he was responsible for multiple IPA and Staff Model Medical Groups providing services to over 500,000 patients.

Karl Rebay, MBA, Partner, Health Care Consulting, Moss Adams

Karl Rebay has over 25 years of experience in the health care industry, and is a leader with our health care consulting practice. He provides financial and operational consulting, market strategy and intelligence, project and strategy feasibility, capitation and value models, negotiation and analysis of managed care contracts, and physician compensation consulting. His clients include health systems, hospitals, health plans, long-term care organizations, and IPAs, among others.

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