decisionhealth Newsletters, Part B News - 2020 Issue 2 (February)
Direct Contracting, launching soon, pushes practices to put more skin in the game
Subscribe or sign in to view the full article.
Article Overview
This article covers the Centers for Medicare & Medicaid Services’ Direct Contracting demonstration model, its relationship to other value-based care initiatives, and the operational and financial changes it may bring for participating organizations. It is aimed at practices, administrators, and coding/reimbursement professionals who need to understand how CMS is reshaping primary care and accountable care payment models, what kinds of organizational requirements are involved, and how the model compares with other Medicare options. The discussion focuses on broad program structure, payment approach, risk-sharing, beneficiary engagement features, and the types of entities likely to find the model relevant.
Why This Topic Matters
Direct Contracting represents a shift in how Medicare may structure payment, risk, and provider organization responsibilities. Understanding the model helps practices assess whether a population-based arrangement may affect their participation in Medicare value-based care programs.
Article Sections
-
Value-based care
Introduces the Direct Contracting demonstration model and places it in the context of CMS’s broader value-based care strategy. It also compares the model at a high level with other Medicare payment initiatives.
-
The house handles the money
Describes how participating entities manage payment flow and assume responsibility for distributing funds within the model. It also outlines the general financial and organizational role of the contracting entities.
-
Other features: Benefit add-ons and more
Summarizes general participant-facing features related to care improvements, engagement incentives, and other model-related flexibilities. It also notes that the model includes different capitation options.
-
Wave of the future?
Provides commentary on which kinds of organizations may be interested in the model and what types of governance and capital considerations are involved. It frames the article’s broader perspective on the model’s significance.
What You Will Learn
- How Direct Contracting fits into CMS’s value-based care and primary care initiatives
- What broad responsibilities participating entities take on under the model
- What types of organizational features and incentives are associated with the program
- Which kinds of practices may be best positioned to consider participation
Who Should Read This
- Medical practices
- Practice administrators
- Health care executives
- Reimbursement and compliance professionals
- Organizations evaluating Medicare value-based care participation
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com