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  • Washington Highlights

    CMS Announces Request for Information on Direct Provider Contracting Models

    Kate Ogden, Physician Payment & Quality Specialist

    The Centers for Medicare and Medicaid Services (CMS) April 23 announced a new Request for Information (RFI) on direct provider contracting models. This RFI follows up on CMS’ Sept. 20, 2017 RFI on a new direction for the Center for Medicare and Medicaid Innovation (CMMI).

    Through this RFI, CMS is seeking input from the public on direct provider contracting scenarios between payers and primary care or multispecialty groups, as well as ways to develop and test a new payment model based around direct provider contracting. In the payment model being considered, Medicare would pay primary care or multispecialty practices a fixed amount per beneficiary each month, and the physicians could earn bonuses based on cost and quality of care. Beneficiaries would choose to be in the model.

    The RFI poses 22 questions to commenters, whose answers will frame topics such as provider/state participation, beneficiary participation, payment, general model design, program integrity and beneficiary protections, and existing CMS initiatives.

    The AAMC will provide comments in response to the RFI. Comments are due May 25.