CMS accepting applications for new primary care alternative payment models

Calculator that says "Medicare" on it on top of money, next to bottle of pills
CMS says its new "direct contracting" program will provide an opportunity for more providers to participate in accountable care organizations. (Getty Images/liveslow)

The Centers for Medicare and Medicaid Services (CMS) announced Monday that is now accepting applications for new primary care alternative payment models.

Called “Direct Contracting”, the program offered by the Center for Medicare & Medicaid Innovation (CMMI), will test an array of financial risk-sharing arrangements, CMS said in a fact sheet.

CMS hopes it will encourage more healthcare providers to participate in value-based care arrangements. It will provide an opportunity to participate for providers that had not been eligible under previous Medicare Accountable Care Organization (ACO) initiatives, such as the Medicare Shared Savings Program and the Next Generation ACO (NGACO) model.

Webinar

Curating a Higher Level of Personalized Care: Digital Health + Mom

A long-term digital health strategy is needed to respond to the technology demands of the modern patient while thriving as an independent hospital in a fiercely competitive market. In this webinar, Overlake and one of its digital health partners, Wildflower Health, will discuss how Overlake has approached digital health and why it chose to focus early efforts on expectant moms within its patient population.

Direct Contracting will offer another model option for Next Generation participants when that program ends in 2020, CMS said.

The announcement was welcomed by groups that are advocating for accountable care organizations.

“The Innovation Center’s Direct Contracting Model is really an ACO by another name and builds off the successful Next Generation ACO Model,” said Clif Gaus, president and CEO of the National Association of ACOs (NAACOS).

He said CMS is demonstrating its commitment to value-based care and payment by moving forward with accountable care models which make providers accountable for patients’ total cost of care. He said the organization is pleased to see CMS give Next Generation participants the option to continue in the program after it ends at the end of next year.

RELATED: Healthcare organizations ask CMS to expand Next Generation ACOs

America’s Physician Groups, an association for accountable physician groups, said it was pleased CMS released the request for applications (PDF). “This is yet another step by CMMI in affirming its commitment to ensuring that patients have access to the high-quality, accountable and coordinated care physician groups have been providing for decades,” said Don Crane, America's Physician Groups president and CEO.

Providers that want to participate in an “implementation period,” which allows them to use the initial year to align beneficiaries, can apply now until February 24. Organizations that want to start in the first performance period beginning January 2021 will be able to apply in spring 2020.

CMS also said it is reopening the letter of intent submissions period until December 10 for organizations that didn’t submit that letter in August. The letter must be submitted in order to submit an application.

“Risk-sharing arrangements properly incentivize physicians to provide high-value, high-quality healthcare to the patients and communities they serve. We look forward to continuing to work with CMMI to put more tools in the toolbox to help physicians who are moving from volume to value,” said Crane.

Suggested Articles

Average list prices for the most common specialties associated with surprise medical bills outpaced growth for all other specialties, analysis finds.

Medicare Advantage rebates to plans are expected to reach historic highs next year, MedPAC analysis finds.

The VA launched the National Artificial Intelligence Institute to prioritize AI R&D to improve veterans' health and public health initiatives.