Medicare Compliance & Reimbursement

If you’re interested in being part of Medicare’s risk and reward revolution, a Direct Contracting payment model might be for you.

Background: Back in May, the Centers for Medicare & Medicaid Services (CMS) introduced a plethora of Innovation Center models that use the same methodology as programs like Medicare Advantage, Accountable Care Organizations (ACOs), and Medicaid Managed Care Organizations. The model options included three Direct Contracting (DC) pathways that encourage competition, coordination, and enhanced care delivery in risk-sharing arrangements (see Medicare Compliance & Reimbursement, Vol. 45, No. 10).

Now: According to Innovation Center guidance, if you didn’t submit a Letter of Intent (LOI) to participate in either the DC Global or Professional model, you still have until Dec. 10 to become part of the program

Fill out the LOI form at  https://app1.innovation.cms.gov/dc.

Plus: The Request for Application (RFA) is also open for the DC Professional and Global payment models with two submission options. You can apply now through Feb. 25, 2020, to be part of the implementation period; however, you also have the option of applying in Spring 2020 to be part of the first performance year, Innovation Center guidance suggests.

See more on the DC payment models, including how to apply, at  https://innovation.cms.gov/initiatives/direct-contracting-model-options.