Cloud Health Office
PROD
🔔
KR

Product Line Context

Platform Engagement — Capitation & Value-Based Care

This dashboard demonstrates Cloud Health Office (CHO)'s Capitation Management capability — per member per month (PMPM) rate configuration, capitation payment runs, and provider settlement. Capitation infrastructure is core value-based-care plumbing for payers managing risk-bearing arrangements with provider groups.

Capitation ships natively in Layer 3 — Full CAPS Platform as part of CHO's financial-domain services. For established payers on a Layer 2 — Progressive Modernization path, capitation is available as a domain replacement; appeals is the current Layer 2 production lighthouse, with capitation following as customer engagements mature the strangler-fig pattern across additional financial domains.

The fee-schedule and provider-contract data infrastructure underneath this UI also reflects CHO's Managed Data Services posture — provider contract data, fee schedule updates, and rate verification are productizable as subscription services for customers who want capitation data services without full Platform Engagement.

See full pricing · Canonical positioning →

🏥 Capitation Management
PMPM rate configuration, capitation payment runs, and provider settlement
Active Cap Contracts
47
across 12 provider groups
Monthly Cap Obligation
$1,847,200
April 2026 cycle
Avg PMPM Rate
$342.18
blended across all LOBs
Members Under Cap
5,398
Medicaid + Commercial
Current Payment Run — April 2026
Under Review
Generated
2
Under Review
3
Approved
4
ACH Submitted
5
Settled
Provider Group Contract # Members PMPM Rate Monthly Amount YTD Paid Payment Method Status
Valley Primary Care Network CAP-2026-001 1,240 $318.50 $394,940 $1,579,760 ACH (CCD) Active
Heritage Family Medicine CAP-2026-002 890 $356.00 $316,840 $1,267,360 ACH (CCD) Active
Lone Star Pediatrics CAP-2026-003 612 $289.75 $177,327 $709,308 ACH (CCD) Active
Gulf Coast OB/GYN Associates CAP-2026-004 445 $412.00 $183,340 $733,360 ACH (CCD) Active
Prairie Health Partners CAP-2026-005 978 $298.25 $291,489 $1,165,956 Stripe Connect Active
Meridian Behavioral Health CAP-2026-006 533 $378.90 $201,954 $807,816 ACH (CCD) Active
Bluebonnet Community Health CAP-2026-007 700 $402.15 $281,505 $1,126,020 Stripe Connect Active