CMMI Widens Direct Contracting Pool With NextGen ACOs

In a move that was not entirely unexpected but irked one leading value-based provider group, CMS recently said it plans to discontinue the Next Generation ACO Model next year and instead allow NextGen ACOs to apply for the Global and Professional Direct Contracting (GPDC) Model for 2022. At least four Medicare Advantage insurers have Direct Contracting Entities (DCEs) that are serving fee-for-service (FFS) Medicare beneficiaries through the GPDC, which launched April 1. And while CMS is not taking applications from other new DCEs at this time, experts say there is still strong MA plan interest in the GPDC, and they should not discount the possibility that the applicant pool will open again, albeit with a few possible tweaks.

In an email sent to participating NextGen ACOs on May 21, CMS said it will end the Center for Medicare and Medicaid Innovation (CMMI) model on Dec. 31 and invited the organizations to apply to join the GPDC starting in performance year 2022 as a Standard Direct Contracting Entity. One of three options for participating in the model, Standard DCEs are composed of organizations that generally have experience serving FFS beneficiaries, including Medicare-only and dual-eligible beneficiaries.

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Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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