CMS releases fact sheet on ‘direct contracting’

The Centers for Medicare & Medicaid Services (CMS) has released a new ‘Direct Contracting: Professional and Global’ fact sheet. CMS says that, “Direct Contracting creates a new opportunity for the [CMS] Center for Medicare and Medicaid Innovation (Innovation Center) to test an array of financial risk-sharing arrangements to reduce Medicare expenditures while preserving or enhancing the quality of care furnished to beneficiaries.”

CMS explains that, “Direct Contracting leverages lessons learned from other Medicare Accountable Care Organization (ACO) initiatives, such as the Medicare Shared Savings Program and the Next Generation ACO (NGACO) Model, as well as innovative approaches from Medicare Advantage (MA) and private sector risk-sharing arrangements.”

It also notes that, “Because the model reduces burden, supports a focus on complex, chronically and seriously ill patients, and aims to encourage organizations to participate that have not typically participated in Medicare fee-for-service (FFS), Innovation Center models, or both, we anticipate that this model will appeal to a broad range of physician organizations and other types of health organizations.”

And CMS points out that, “Direct Contracting provides an opportunity to participate in a value-based care arrangement under Medicare FFS for health care providers that have not previously been eligible for the Shared Savings Program, the NGACO Model, or both due to an insufficient number of assigned or aligned Medicare FFS beneficiaries…[and it] offers another model option for NGACO Model participants to consider after NGACO ends in 2020.”

CMS ‘Direct Contracting: Professional and Global’ fact sheet

CMS ‘Direct Contracting Model Options’ web page