CMMI Direct Contracting Model: HFMA Overview
On April 22, 2019, the Center for Medicare and Medicaid Innovation (CMMI) announced its Direct Contracting (DC) model. The five-year model builds on CMMI’s and providers’ experiences with the Next Generation Accountable Care Organization (ACO) program. The payment model options available under DC create opportunities for a broad range of organizations to participate with the Centers for Medicare & Medicaid Services (CMS) in testing the next evolution of risk-sharing arrangements to produce value and high-quality health care. Building on lessons learned from initiatives involving Medicare ACOs, such as the Medicare Shared Savings Program (MSSP) and the Next Generation ACO (NGACO) Model, the payment model options available under DC also leverage innovative approaches from Medicare Advantage (MA) and private sector risk-sharing arrangements. The program will begin in 2020 with an “initial alignment year” for organizations to meet the minimum beneficiary requirements with the risk bearing period, which lasts for five years, beginning on January 1, 2021.