Direct provider contracts would cut payers out of the equation, allowing CMS to contract directly with physician group practices or other Medicare providers. This model of care puts more emphasis on patients choosing a primary care practice and on physicians creating a long-term relationship with patients and taking on two-sided financial risk for their care.
“Direct provider contracting would enhance the beneficiary-physician relationship by providing a platform for physician group practices to provide flexible, accessible, and high quality care to beneficiaries that have actively chosen this type of care model,” the RFI reads.
Because direct provider contracting is present in some ways in existing CMS initiatives, such as ACOs, the RFI asks for input on how these models would interface with each other. It also calls for input on created direct provider contracts in Medicaid.
Comments are due May 25 to dpc@cms.hhs.gov. Find out more about the specific questions CMS is soliciting here.
More articles on payer issues:
Humana divests 2 business lines to Texas insurer
Aetna’s Q1 net income swings to $1.2B without Humana merger costs
America’s uninsured rate climbs to 15.5%
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit