Mar 20, 2023
Insights for ACOs | November 27, 2019
After months of waiting, the Center for Medicare & Medicaid Innovation (CMMI) released details on the Direct Contracting Payment model options on Monday via a Request for Application. The 100-page document tells us many details about the model but leaves several key questions unanswered. Below, we share a summary and first reactions. We’ll be following up in the coming days with additional perspectives as we more thoroughly interpret the details. Join us online next Tuesday, December 3rd to discuss the details and strategic implications of the models.
The Direct Contracting model represents an exciting step in CMS’ progression towards value-based care. It builds on the momentum of and applies lessons learned from the shared savings programs. It intends to promote the delivery of integrated care for patients and a better professional experience for providers. It allows the ACO community to continue pushing the envelope in innovative care models.
However, the permutations of Direct Contracting broaden the range of decisions that organizations have before them and the level of risk magnifies the ramifications of these decisions. These decisions should therefore increasingly rely on precise analysis rather than approximations.
The clock is ticking. ACOs, Risk-Bearing Entities, providers must convene their governing bodies and make participation decisions by April of next year. The decision is most acute for current NextGen ACOs, as they will need to decide between Direct Contracting and Pathways.
This article was originally published on LinkedIn on November 27, 2019, by Erik Fiske. You can find the article here.