“Being Ethical and Doing the Right Thing Will Ultimately Lead to Success.”
Samuel M. DiCapua is a distinguished healthcare executive, physician leader, entrepreneur, and board advisor whose career spans more than three decades at the intersection of healthcare delivery, health insurance, clinical governance, and organizational leadership. Throughout his professional journey, he has earned a reputation for combining deep clinical expertise with strategic business acumen, helping organizations navigate complexity, improve quality outcomes, manage financial performance, and create sustainable growth. His unique ability to understand healthcare from both the provider and payer perspectives has positioned him as a trusted leader capable of bridging competing priorities while maintaining an unwavering commitment to patient care, ethical leadership, and operational excellence.
Dr. DiCapua’s healthcare journey began with a passion for medicine and service. After earning his Bachelor of Science in Biology and subsequently completing a Master of Science in Human Anatomy from Fairleigh Dickinson University, he pursued his Doctor of Osteopathic Medicine degree at the University of New England. His educational foundation provided not only extensive clinical knowledge but also a deep appreciation for the science, humanity, and complexity of healthcare. Following residency training in Family Practice, he embarked on what would become a remarkable career dedicated to improving healthcare systems and outcomes at every level.
Early in his career, Dr. DiCapua established Wells Family Practice in Wells, Maine, where he served as Founder, Managing Partner, and practicing physician for more than thirty years. During a period when many independent medical practices were being absorbed into larger health systems, he successfully maintained the independence and profitability of his practice while continuing to provide exceptional patient care. Leading every aspect of the organization—from clinical operations and staffing to finance and strategic planning—he developed a firsthand understanding of the challenges facing healthcare providers. This entrepreneurial experience became one of the defining elements of his leadership philosophy, teaching him how to balance quality care with operational efficiency and financial sustainability.
As healthcare reimbursement models evolved, Dr. DiCapua continuously adapted and innovated. He successfully guided his practice through multiple payment reform initiatives, including fee-for-service, capitation, pay-for-performance, and value-based care arrangements. Rather than viewing industry disruption as a threat, he embraced change as an opportunity to improve care delivery and organizational performance. His ability to evolve with the healthcare landscape while preserving the independence of his practice demonstrated a level of strategic foresight and resilience that would later become hallmarks of his executive leadership career.
Recognizing the broader impact he could make within healthcare systems, Dr. DiCapua transitioned into medical management and health plan leadership. His roles with Cigna Healthcare and Martin’s Point Health Care expanded his expertise in utilization management, care coordination, disease management, quality improvement, and health plan operations. During this period, he gained extensive experience evaluating medical necessity, developing clinical policies, and aligning healthcare delivery with evidence-based standards. These experiences provided him with a comprehensive understanding of the operational mechanisms that drive quality, affordability, and access across healthcare organizations.
Dr. DiCapua’s leadership trajectory accelerated when he joined Centene Corporation, one of the nation’s largest healthcare enterprises. Over nearly twelve years with the organization, he held progressively senior leadership roles, culminating in his appointment as Chief Medical Officer for the Ambetter Marketplace Product. Throughout his tenure, he became recognized as a transformational leader capable of delivering measurable improvements in quality, compliance, operational effectiveness, and financial performance. His leadership extended across Medicaid, Medicare, and Affordable Care Act populations, serving millions of members in highly regulated and competitive markets.
As Chief Medical Officer, Dr. DiCapua led clinical strategy, medical cost management, care management effectiveness, and quality improvement initiatives within one of the nation’s largest healthcare organizations. He became particularly known for his ability to identify systemic inefficiencies and implement practical solutions that generated significant financial and operational value. Among his notable accomplishments was the identification and correction of misalignments between clinical policy, claims configuration, and payment processes, initiatives that contributed more than $30 million in measurable savings. By bringing together clinical, operational, and financial stakeholders, he demonstrated how thoughtful governance and strategic leadership can simultaneously improve outcomes and strengthen organizational performance.
Beyond financial performance, Dr. DiCapua has consistently championed quality improvement and patient-centered care. Under his leadership, NH Healthy Families achieved a prestigious NCQA 4-Star quality rating, becoming one of the highest-performing Medicaid health plans in the state. He also played a critical role in securing and renewing major Medicaid contracts, helping ensure organizational growth and long-term sustainability. His ability to navigate complex regulatory environments while maintaining a focus on quality and member outcomes has made him a respected voice among healthcare executives, policymakers, providers, and regulators alike.
One of Dr. DiCapua’s most valuable attributes is his rare dual perspective as both a long-practicing physician and a senior healthcare executive. Having spent decades delivering care directly to patients while simultaneously leading health plan operations, he understands the motivations, challenges, and objectives of both providers and payers. This unique perspective enables him to build consensus among diverse stakeholders and identify solutions that create value across the healthcare ecosystem. His expertise spans medical cost management, value-based care strategy, clinical governance, regulatory compliance, provider engagement, fraud prevention, quality improvement, and healthcare transformation.
In addition to his executive accomplishments, Dr. DiCapua has demonstrated a longstanding commitment to education, mentorship, and community service. As a Family Practice Preceptor at Central Maine Medical Center, he helped train and mentor future generations of physicians. His dedication to professional development and leadership excellence is reflected in his attainment of both Certified Physician Executive (CPE) and Certified Healthcare Insurance Executive (CHIE) designations. These credentials underscore his commitment to continuous learning and his belief that effective leadership requires both expertise and humility.
Today, Dr. DiCapua continues to leverage his extensive experience through board service, advisory work, and executive consulting. As Founder of Onesta Enterprises, LLC, he advises healthcare organizations facing challenges related to medical cost performance, quality outcomes, operational alignment, and regulatory complexity. He also serves as Trustee of the Davis Family Foundation, where he provides governance oversight and helps guide philanthropic investments supporting education, healthcare, and cultural initiatives. These roles reflect his enduring desire to contribute meaningfully to organizations that seek to improve lives and create lasting impact.
Throughout every stage of his career, Dr. DiCapua has remained guided by a simple but powerful philosophy: doing the right thing is always the right strategy. Whether leading large healthcare enterprises, operating an independent medical practice, advising executive teams, or serving on boards, he approaches every challenge with integrity, accountability, and a commitment to ethical leadership. His career demonstrates that long-term success is built not only on expertise and results but also on trust, transparency, and a genuine dedication to serving others.
Organizations seeking board leadership benefit greatly from Dr. DiCapua’s unique combination of clinical expertise, operational insight, governance experience, and strategic perspective. His ability to understand healthcare from every angle—provider, payer, executive, entrepreneur, and board member—positions him as an invaluable advisor for organizations navigating growth, transformation, regulatory complexity, and industry disruption. As healthcare continues to evolve, Dr. DiCapua remains committed to helping organizations achieve sustainable success while improving the quality, accessibility, and affordability of care.
Character:
Samuel DiCapua has built his career on a foundation of integrity, accountability, and ethical decision-making. He consistently prioritizes doing what is right for patients, organizations, and stakeholders, even when faced with difficult decisions. His reputation as a trusted leader stems from his unwavering commitment to transparency, professionalism, and service.
Knowledge:
With more than thirty-five years of experience spanning healthcare delivery, managed care, medical management, and executive leadership, Dr. DiCapua possesses an exceptional depth of industry knowledge. His expertise extends across payer and provider environments, giving him a uniquely comprehensive understanding of healthcare operations and strategy. He combines clinical insight with business acumen to solve complex organizational challenges and improve performance.
Strategic:
Dr. DiCapua has repeatedly demonstrated the ability to identify opportunities, navigate change, and implement initiatives that drive measurable results. His leadership has produced significant cost savings, quality improvements, and organizational growth across multiple healthcare organizations. He approaches every challenge with a long-term perspective focused on sustainability, innovation, and stakeholder value.
Communication:
Throughout his career, Dr. DiCapua has excelled at building relationships and fostering collaboration among physicians, executives, regulators, board members, and community stakeholders. He translates complex clinical, operational, and financial concepts into clear, actionable insights that support informed decision-making. His ability to communicate with credibility and empathy has made him an effective leader, mentor, advisor, and board contributor.
