Direct Contracting Risk-Sharing Options: Submit Letter of Intent by December 10
Direct contracting creates a variety of pathways for health care providers and suppliers to take on financial risk supported by enhanced flexibilities. Because the model reduces burden, supports a focus on complex, chronically and seriously ill patients, and aims to encourage organizations to participate that have not typically participated in Medicare fee-for-service, Innovation Center models, or both, the Centers for Medicare & Medicaid Services (CMS) anticipates that this model will appeal to a broad range of physician and other types of health organizations.
It will test two voluntary risk-sharing options:
- Professional: Lower-risk option (50% shared savings/shared losses) and primary care capitation equal to 7% of the total cost of care benchmark for enhanced primary care services
- Global: Full risk option (100% shared savings/shared losses) and either primary care capitation or total care capitation
See the full text of this excerpted CMS Fact Sheet.