Direct Contracting Risk-Sharing Options: Submit Letter of Intent by December 10

December 5, 2019
Policy Snapshot

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

The Letter of Intent (LOI) is open until December 10 for those organizations that did not submit an LOI previously. Visit the Direct Contracting Model Options webpage for more information.

See the full text of this excerpted CMS Fact Sheet.