Medicare Direct Contracting Demo Garners Critics and Defenders

MedPage Today January 4, 2022
Joyce Frieden

— Program allows ACOs, insurers to provide care to fee-for-service beneficiaries

WASHINGTON — As the Biden administration continues to move Medicare reimbursement from volume-based payment to payments based on value, officials are expanding those efforts to include providers who care for “traditional” Medicare patients and currently bill under a fee-for-service system.

The new Direct Contracting program, a demonstration program that began under the Trump administration, allows “a broad range of organizations to participate with the Centers for Medicare & Medicaid Services (CMS) in testing the next evolution of risk-sharing arrangements,” according to a CMS fact sheet.

How the Program Works

The program offers three different types of direct contracting models, including “both capitated and partially capitated population-based payments that move...

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