Health Affairs September 30, 2021
Richard Gilfillan, Donald M. Berwick

In Part one of this two-part post, we explored the reasons for surging growth and profits in the Medicare Advantage (MA) program and the dynamics, largely related to risk-coding games, that make MA a costly form of transfer of public and beneficiary dollars into private hands. In Part two below, we explore the approach fostered originally by the Trump Administration to implant those same dynamics into the traditional Medicare side of the Centers for Medicare and Medicaid Services (CMS) ledger in the form of the misnamed “Direct Contracting” model. We then offer policy recommendations to restore balance and efficiency to MA and further alternative payment models for traditional Medicare.

Direct Contracting: The Path To Medicare Privatization

Given an Orwellian...

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Topics: ACO (Accountable Care), CMS, Govt Agencies, Health System / Hospital, Healthcare System, Insurance, Medicaid, Medicare, Patient / Consumer, Payer, Payment Models, Physician, Primary care, Provider, Value Based
Voices: Thomas Kim, MD, MMM, FHM, Chief Medical Officer, Sound Long-Term Care Management
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