“I think it’s designed to increase the number of organizations participating in value-based contracts with a clear bias towards primary care practices, as the focus for expansion,” he said, “and if you look at how CMMI developed Direct Contracting, they were probably looking at a fair amount of the work that’s being done by Medicare Advantage plans in how they’re establishing contracts, with a tight focus on the concept of advanced primary care. These are practices that have made the investment in social care coordinators, mental health providers, behavioral health providers — trying to look at the management of patients in as comprehensive a way as possible.”

The Comprehensive Primary Care program and CPC+ are extensions of what CMS and other purchasers did around Patient Centered Medical Home practices, he added. They wanted to see if they could use that as an investment to do some more care coordination and curating. The ACO program, on the other hand, was very much geared towards hospitals and health systems.

CMS says that 53 Direct Contracting Entities are participating in the first Performance Year of the model, which runs from April 1, 2021, through Dec. 31, 2021. The goals include creating opportunities for a broad range of organizations to participate with CMS in testing the next evolution of risk-sharing arrangements. “The risk-sharing options are anticipated to appeal to a broad range of physician practices and other organizations because they are expected to reduce burden, support a focus on beneficiaries with complex, chronic conditions, and encourage participation from organizations that have not typically participated in Medicare FFS or CMS Innovation Center models,” according to the CMS website.

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