Direct Provider Contracting: Keep It Simple, Stakeholders Tell CMS

Jun 8, 2018 | Uncategorized

Direct Provider Contracting: Keep It Simple, Stakeholders Tell CMSFor the most part, providers support the Direct Provider Contracting proposal put forward by the Centers for Medicare & Medicaid Services, with some stipulations and considerable tweaking. Check out the article, below, for more information! nnKey stakeholders are mostly supportive of a Medicare Direct Provider Contracting proposal but urging the federal government to keep it simple and not overwhelm providers with paperwork.nn“Burden reduction must be a priority for the Innovation Center when implementing the DPC model,” the Medical Group Management Association said in a letter to the Centers for Medicare & Medicaid Services.nn“Collecting and reporting quality metrics remain technically challenging, data intensive, and administratively burdensome,” MGMA said. “Bureaucratic barriers to care, including prior authorization and appropriate use criteria, are at odds with care delivery and financial models in which participants are accountable for care outcomes.”nnThat concern was echoed byThe American Geriatrics Society, which urged that “CMS take care not to add further administrative burdens that may negatively impact patient care.”nnThe National Association of Accountable Care Organization supports the DPC concept, but urged CMS to limit participation to primary care providers for the rollout.nn“Primary care is more appropriate for this type of model, and specialty DPC Models would be too similar to bundled payment programs,” NAACOS said. “Further, it would be much more complicated to structure per beneficiary per month payments for specialty care which is typically more complex and can include episodes of care with greater variation in clinical conditions, treatment protocols and related costs.”n

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