Don’t let lucrative carve outs slip through the cracks.

Medical staff teamwork


Value-based care is growing in popularity amongst clinics and independent practices. It encourages providers to take the best care of patients, including proactive preventative care. Taking advantage of capitation models is a great way to also ensure consistent income. Some insurance companies and payers are quick to lump all care under capitation however. 

OpenPM serves as a value-based care practice’s watchdog. Open Practice’s software analyzes existing capitation agreements, per member per month (pmpm) rates, and defined carve outs. It will then properly assess all care provided, and ensure that no potential revenue slips through the cracks. Providing care outside of previously agreed upon parameters will automatically code and bill properly within OpenPM, ensuring full and accurate billing.

Please read this case study on how Open Practice assisted a client: Maui Medical They are an 80+ provider, multi-specialty, multi-location practice with custom capitation reporting. Utilizing OpenPM helped to save them time, money, and big headaches.

link to Capitation and Management Reporting