CMS Seeks Input on Potential Models for Direct Provider Contracting

The Centers for Medicare & Medicaid Services seeks comments through May 25 on potential models for direct provider contracting (DPC) with physician practices in Medicare, Medicaid and the Children’s Health Insurance Program to reduce spending and administrative burden while enhancing quality and engaging patients and families in their care. CMS’s Center for Medicare and Medicaid Innovation proposes initially testing a Medicare DPC model with primary care practices, through which CMS would pay participating practices a monthly per beneficiary fee for certain primary care services provided to patients enrolled in the model and offer practices certain quality and cost incentives. Beneficiaries would voluntarily enroll in DPC practices, which would have access to tools to engage patients in taking responsibility for their health. The model also would test ways to ease burdens in the claims submission process. The request for information includes several questions related to provider/state participation in DPC models, beneficiary participation, payment, general model design, program integrity and beneficiary protections, and existing accountable care models. AHA plans to submit comments.