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.
CMMI Direct Contracting Model: HFMA Overview
Related Articles | Payment Models
Aetna rolls out a no-cost sharing primary care offering for members at CVS Minute Clinics and HealthHUBS
HFMA's Chad Mulvany says it’s not surprising that Aetna would use its Minute Clinics as the basis of a primary care network for lower-cost health plans.
Business Group on Health's Annual Survey: Large employers ready to take the reins on healthcare cost
Responses to the Business Group on Health's annual survey of its large employer members suggest employers are tired of waiting for providers and plans to figure out how to reduce healthcare cost.
Offering long-term payment plans to meet the financial needs of patients
A forward-thinking bank talks about its accessible patient finance program, which gives patients a way to afford care while ensuring timely payment for healthcare organizations.
Primary care providers are partnering with employers to form an optimal primary care delivery system
HFMA's Katie Gilfillan says the time may be right for a re-orientation of the healthcare system, where hospitals, physician groups and purchasers of care along with payment models are aligned to support a more patient-centric system.