tci Medicare Compliance & Reimbursement - 2019 Issue Q4

Industry Note: Applications Are Open for Direct Contracting Models

If you’re interested in being part of Medicare’s risk and reward revolution, a Direct Contracting payment model might be for you. Background: Back in May, the Centers for Medicare & Medicaid Services (CMS) introduced a plethora of Innovation Center models that use the same methodology as programs like Medicare Advantage, Accountable Care Organizations (ACOs), and Medicaid Managed Care Organizations. The model options included three Direct Contracting (DC) pathways that encourage competition, coordination, and enhanced care delivery in risk-sharing arrangements (see Medicare Compliance & Reimbursement, Vol. 45, No. 10). Now: According to Innovation Center guidance, if you didn&rsquo...

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