News Briefs: CMS Unveils Change to Direct Contracting Model

CMS on Feb. 24 released plans to revamp the Global and Professional Direct Contracting model, which allows participants to share risk and receive capitated payments for serving fee-for-service Medicare beneficiaries. Democrats like Washington Rep. Pramila Jayapal and Massachusetts Sen. Elizabeth Warren have criticized the model for transforming “the care of a traditional Medicare beneficiary to care typically seen in a private Medicare Advantage (MA) plan despite the fact that the patient chose not to enroll in an MA plan,” in Jayapal’s words. However, in good news for insurers like Clover Health, which are counting heavily on direct contracting revenue, CMS appears to still allow health insurers to apply for the renamed ACO Realizing Equity, Access, and Community Health (REACH) Model. As part of the overhaul, CMS promised greater “participant vetting, monitoring and transparency,” more promotion of provider leadership and governance, and a larger focus on health equity, among other changes.

0 Comments
© 2022 MMIT
AIS Health Staff

AIS Health Staff

Related Posts

golden-gate-bridge
September 23

West Coast Public Sector Plan Sponsors Will Coordinate More Closely Through Purchaser Group

READ MORE
remote-patient-monitoring-and-phone
September 23

Spike in Remote Patient Monitoring During Pandemic Is Driven by a Fraction of Providers

READ MORE
humana-headquarter
September 23

Humana Will Buy One Primary Care Group — and Could Snap Up Another

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today