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Blended Capitation Model (BCM)

Blended Capitation Model

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 Clinical Alternative Relationship Plan demonstration project supported in partnership by AMA ACTT and Alberta Health.

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.

The benefits to BCM, include:

  • Continuity where relationships matter
  • Care coordination and delivery by an interdisciplinary team
  • Good access to care and a patient-centred approach
  • The ability to deliver care in innovative ways
  • Professional autonomy and satisfaction
  • Happier, healthier patients
  • Predictable income stream for easier budgeting and stability

BCM Journey

  1. STEP 1 | Explore the model

    Please refer to the BCM Frequently Asked Questions to explore initial information about the model.

    FAQ - BCM

  2. STEP 2 | Orientation

    Clinics seeking more information or who are interested in joining the model are invited to review the following materials:

    Orientation Video - BCM Basket of Services Table - BCM

    Once these have been reviewed, the BCM implementation team will be happy to meet with your clinic to share more about the Blended Capitation Model, answer questions, and explore if it's right for you.

    Our team can be contacted at: actt@albertadoctors.org

    If your clinic decides after the orientation, that you would like to proceed with BCM:

    • Please complete the Clinic Baseline Assessment Intake Form.
    • Your Intake Form will be reviewed by the ACTT BCM team. 
    • The ACTT Team will then contact you to establish if you would like to proceed with Financial Modelling. 

  3. STEP 3 | Financial modelling

    As 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. STEP 4 | Application

    A formal application submission is required as your participation in the Blended Capitation Model is through a Ministerial Order with Alberta Health.

  5. STEP 5 | Implementation

    You will receive support from your BCM implementation team to operationalize the model including:

    • support for process redesign (administrative and clinical) 
    • access and training around reports related to BCM
    • an opportunity to be part of the BCM community of practice.

    There are several tools to help support your clinic with going live, including:

    Patient Affiliation Script Pathway - BCM Patient Affiliation Email Example - BCM Practice Agreement Guide - BCM Practice Agreement Discussion Notes Template - BCM Financial Distribution Hourly Calculation Spreadsheet Example - BCM

    Currently in development - Financial distribution panel calculation

  6. STEP 6 | Maintenance

    Once your clinic has gone live, the shadow negation reports should be reviewed regularly as part of the clinic routine.

    Automated reminder negation emails will be sent to the clinic at intervals to prompt review of shadow negation reports.

    The clinic must also continue to affiliate patients. Automated reminder patient affiliation emails will be sent at intervals to prompt continuation of patient affiliation.

    Currently in development - BCM Toolkit 

Want to know what others think about BCM?

See what your colleagues are saying about their experiences with the BCM demonstration project.

Hear From Your Peers!

 

Additional Resources

Practice Agreement Guide - BCM Patient Affiliation - BCM Rate Methodology Overview - BCM