CHA News

CMS Opens Application Period for Direct Contracting Models

For CFOs, CMOs

The Centers for Medicare & Medicaid Services (CMS) has opened the application period for two voluntary Direct Contracting Model options: professional and global. Applicants interested in participating in the implementation period must submit applications by Feb. 25; the application tool will be available later this month. In spring 2020, CMS will announce a separate application period for organizations that wish to participate in the first performance year. Organizations that are considering applying must submit a letter of intent by Dec. 10, if they have not already done so.

The professional model option offers a lower-risk sharing arrangement — 50% savings and losses — and provides primary care capitation, a capitated, risk-adjusted monthly payment for enhanced primary care services. The global model option offers the highest risk sharing arrangement — 100% savings and losses — and provides two payment options: primary care capitation or total care capitation, capitated, risk-adjusted monthly payment for all services provided by direct contracting participants and preferred providers with whom the direct contacting entity has an agreement. CMS plans to announce a third participation option — the geographic model — in the future. More information is available in a CMS fact sheet.