CMMI pauses new Direct Contracting model applications

CMS’ Center for Medicare and Medicaid Innovation said on Thursday that it wouldn’t accept new applications for the Global or Professional tracks of its Direct Contracting model in 2022, a decision that could force Next Generation accountable care organizations into the Medicare Shared Savings Program next year unless the agency makes more changes.

It’s the latest tweak to CMMI’s payment experiments following Liz Fowler’s appointment to lead agency. Regulators paused the Geographic Direct Contracting model last month, as several key stakeholders complained the model was too complicated to put into practice. The agency also pumped the brakes on other alternative payment models like the Community Health Access and Rural Transformation model.

CMMI developed the Direct Contracting model to encourage a broad range of organizations to take part in risk-sharing arrangements and build on lessons learned from ACOs and Medicare Advantage. Part of the agency’s plan was to transition existing ACOs to the new model. But that’s no longer an option.

Now the National Association of ACOs is amping up its call for CMMI to extend the Next Gen ACO model.

“Next Generation ACOs need clarification on what happens to their participation in high-risk, accountable care models. Next Gen offers a better option and bridge to capitation than the Shared Savings Program,” NAACOS CEO Clif Gaus said in a statement.

CMMI also announced that 53 entities would take part in the Global and Professional Direct Contracting model’s first performance year, which started April 1 and runs through the end of the year. Nearly all took part in the optional implementation period, which didn’t hold participants accountable for costs or quality.

CMS did not respond to a request for comment.


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