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Providers, payers see direct contracting's capitation as an important move to value-based care

Photo: Cecilie Arcurs/Getty Images
Over the past several years, the big trend in healthcare has been to inch away from fee-for-servicereimbursement and toward value-based care, in which a provider s reimbursement is tied more to clinical quality than to volume. The industry, policymakers and the federal government have attempted this shift through a number of legal and regulatory means, and one policy that has proven popular in this regard, among both providers and payers, is direct contracting.
In basic terms, direct contracting is a population-based model that allows for the use of capitation. This is what sets it apart: Aside from Next Gen and Pioneer, virtually all of the other compensation-based models from the Centers for Medicare and Medicaid Services are billed as fee-for-service, with a reconciliation 18 months later. ....

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CMS pushes back kidney care payment model start date to January 2022

CMS pushes back kidney care payment model start date to January 2022
healthcaredive.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from healthcaredive.com Daily Mail and Mail on Sunday newspapers.

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Healthcare Policies: Senate COVID-Relief Expected to Pass

Friday, March 5, 2021
McDermott+Consulting is pleased to provide the McDermottPlus Check-Up, your regular update on health care policy from Washington, DC.
This Week’s Dose
The Senate is expected to pass its version of coronavirus (COVID-19) relief legislation as early as this weekend after the House passed its package along party lines late last week. The Senate Finance Committee sent the nomination of Xavier Becerra to be Secretary of the US Department of Health and Human Services (HHS) to the Senate floor.
Congress
Congress Advanced COVID-19 Relief Package
After the House of Representatives passed the $1.9 trillion COVID-19 relief package, known as the American Rescue Plan, by a largely party-line vote of 219-212 late last week, the Senate quickly released its own version and took up consideration of the bill. The Senate version is substantially similar to the House version, but contains key changes, including an additional $8.5 billi ....

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CMMI's geographic direct contracting model needs an overhaul, experts say

CMMI s geographic direct contracting model needs an overhaul, experts say
Modern Healthcare Illustration / Getty Images
Consumer advocates, accountable care organizations and several experts think CMS Center for Medicare & Medicaid Innovation should delay its Geographic Direct Contracting model dubbed Geo until it resolves a number of issues that could create significant confusion among Medicare beneficiaries and operational and financial challenges for providers.
The model builds on the lessons learned from the Medicare Shared Savings Program, Next Generation ACO model, Medicare Advantage and other initiatives. It s supposed to test whether a regional approach to care delivery and value-based payment can improve health and lower costs for fee-for-service Medicare beneficiaries throughout an entire geographic region. According to a Commonwealth Fund blog post, the model will have the effect of enrolling Medicare beneficiaries into a managed care-like plan. ....

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