HealthLeaders Media May 18, 2022
To help reduce Medicare expenses while preserving or enhancing the quality of care provided to beneficiaries, the Centers for Medicare & Medicaid Services (CMS) introduced its Direct Contracting model in 2019.
The model builds on Next Generation Accountable Care Organization (ACO) concepts and combines them with designs from Medicare Advantage and commercial risk-sharing arrangements.
How Direct Contracting Works
To create a Direct Contracting Entity (DCE), health care providers and suppliers come together under a common legal structure and enter an arrangement with CMS that requires accepting financial accountability for the overall quality and cost of medical care furnished to Medicare fee-for-service (FFS) beneficiaries aligned to the DCE.
Incentives are heavily weighted toward health outcomes and patient satisfaction versus administrative...
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