Does anyone know about, have an opinion on the Medicare Direct Contracting Model?
The Biden administration is reviewing a controversial payment model that would tie Medicare payments to spending and quality for an entire region.
CMS announced the model back in December 2020, and a request for applications was posted Jan. 15. At the time, the agency announced it would have two three-year performance periods, with the first to run from Jan. 1, 2022 to Dec. 31, 2024. Another will run from Jan. 1, 2025 through 2027.
However, the Biden administration has undertaken a review of existing regulations that were passed at the last minute by the Trump administration. For example, the agency appeared to pull a final rule announced in January that aimed to streamline prior authorization requests.
One of the concerns was that beneficiaries may not know they are getting care from a provider in the model.
“The vast majority of beneficiaries will have no idea what a geographic [direct contracting entity] is and what mandatory beneficiary participation will mean for their care and existing provider relationships,” the association wrote. “For example, there is the potential for duplicative care or competing care management programs from a Geographic DCE and the providers the patient sees, who may or may not be participating with the Geographic DCE.”
CMS pushes pause on controversial Geographic Direct Contracting model
The DCM is modeled after the failed ACO model used during the early days of Obamacare.
The Geographic Direct Contracting Model (also known as the “Model” or “Geo”) is a new payment and service delivery model being tested by the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center). The Model will test whether a geographic-based approach to care delivery and value-based care can improve health and reduce costs for Medicare beneficiaries across an entire geographic region. Leveraging best practices and lessons learned from leveraging lessons learned from other Medicare Accountable Care Organization (ACO)shared savings initiatives, such as the Medicare Shared Savings Program (Shared Savings Program) and the Next Generation ACO (NGACO) Model, as well as innovative approaches from Medicare Advantage (MA), Medicaid Managed Care, and private sector risk-sharing arrangements
Geographic Direct Contracting Model | CMS Innovation Center
One of my YT followers alerted me to the DCM attempted hijack of traditional Medicare.
The Biden administration is reviewing a controversial payment model that would tie Medicare payments to spending and quality for an entire region.
CMS announced the model back in December 2020, and a request for applications was posted Jan. 15. At the time, the agency announced it would have two three-year performance periods, with the first to run from Jan. 1, 2022 to Dec. 31, 2024. Another will run from Jan. 1, 2025 through 2027.
However, the Biden administration has undertaken a review of existing regulations that were passed at the last minute by the Trump administration. For example, the agency appeared to pull a final rule announced in January that aimed to streamline prior authorization requests.
One of the concerns was that beneficiaries may not know they are getting care from a provider in the model.
“The vast majority of beneficiaries will have no idea what a geographic [direct contracting entity] is and what mandatory beneficiary participation will mean for their care and existing provider relationships,” the association wrote. “For example, there is the potential for duplicative care or competing care management programs from a Geographic DCE and the providers the patient sees, who may or may not be participating with the Geographic DCE.”
CMS pushes pause on controversial Geographic Direct Contracting model
The DCM is modeled after the failed ACO model used during the early days of Obamacare.
The Geographic Direct Contracting Model (also known as the “Model” or “Geo”) is a new payment and service delivery model being tested by the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center). The Model will test whether a geographic-based approach to care delivery and value-based care can improve health and reduce costs for Medicare beneficiaries across an entire geographic region. Leveraging best practices and lessons learned from leveraging lessons learned from other Medicare Accountable Care Organization (ACO)shared savings initiatives, such as the Medicare Shared Savings Program (Shared Savings Program) and the Next Generation ACO (NGACO) Model, as well as innovative approaches from Medicare Advantage (MA), Medicaid Managed Care, and private sector risk-sharing arrangements
Geographic Direct Contracting Model | CMS Innovation Center
One of my YT followers alerted me to the DCM attempted hijack of traditional Medicare.
