CMS Floats Concept of Direct Provider Contracting Innovation Model, Posts Comments on “New Direction” RFI

Last fall, CMS requested public comments on the CMS Innovation Center’s “New Direction,” under which CMS will seek to “promote patient-centered care and test market-driven reforms.” In the interest of transparency and to facilitate discussion, CMS has posted a summary of the more than 1,000 comments it received from medical societies, providers, manufacturers, and other organizations in response to this solicitation. CMS also has outlined its next potential innovation model — the “direct provider contracting” (DPC) model. Under this concept, CMS would directly contract with primary care or multi-specialty group practices that would agree to be accountable for the cost and quality of care of a defined beneficiary population. For instance, under a primary care-focused DPC model, CMS could pay primary care practices a fixed per beneficiary per month (PBPM) payment to cover applicable primary care services (e.g., office visits,…

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