Direct Contracting

Background
The Direct Contracting Model builds upon the successful Next Generation ACO Model and offers higher levels of risk and reward than the Medicare Shared Savings Program. There are at least two options, Professional and Global, each with three types of Direct Contracting Entities; Standard, New Entrant and High Needs Populations. The six-year model launched with an implementation period in October 2020 and its first performance year on April 1, 2021.

Questions or feedback about the model are welcomed and can be sent to [email protected]. 

Overview 

• CMMI’s Direct Contracting webpage

• CMS offers more details in this factsheet 

• CMS’s Request for Applications and FAQs

CMS Resources

• CMS posts key dates for Direct Contracting Entities in 2021
  
  

• Participation Agreement for Performance Year 1 

• Guidance on Contractual Agreements with Downstream Providers 

• Financial Guarantee Guidance for Direct Contracting Entities 

• Quality Measurement Methodology paper for the Professional and Global options
  
  
• CMS guidance on Benefit Enhancements and Beneficiary Engagement Incentives 
  
  
• An Overview of Direct Contracting for State Regulators
  
  
• Direct Contracting Financial Methodology Papers 
  
  
• Slides from CMS's Dec. 17 webinar on Financial Reconciliation 
  
  
• Operating Policies: Reconciliation 
  
  
• Slides from CMS’s Sept. 18 webinar on the Financial Methodology
  
  
• Finance-Focused FAQs from October 2020
  
  
• CMS FAQs on Direct Contracting from October 2020
• Voluntary Alignment FAQs
  
  
• Benefit Enhancements FAQs
  
  
• CMS FAQs on participation management 
  
  
• CMS Innovation Center announces model changes because of COVID-19
  
  
• Welcome Packet for Direct Contracting Implementation Period Participants 
• Beneficiary Notification Letter 
• Voluntary Alignment Template 

NAACOS Member Resources 

• Overview of financial updates and PY2 Participation Agreement 
  
  
• Key Takeaways from the PY1 Participation Agreement 
  
  
• NAACOS Overview of Direct Contracting Quality Measurement Methodology 
  
  
• NAACOS Summary of Direct Contracting Financial Specifications 
  
  

• NAACOS Frequently Asked Questions on the Direct Contracting Model 

• NAACOS in-depth analysis of the Direct Contracting Model 
  
  
• NAACOS overview of Direct Contracting
  
  
• NAACOS chart comparing Direct Contracting and other high-risk ACOS 
  
  
• NAACOS chart of CMS Innovation Center models and their overlap with ACOs 
  
  
• NAACOS Direct Contracting Listserv 
  
  
• Webinars
• September 15, 2021 Learning Discussion 
  
  
• August 11, 2021 Learning Discussion 
  
  
• Direct Contracting 101: Understanding the Basics 
  
  
• Direct Contracting - Financial Needs for High Needs Population DCEs
  
  
• Direct Contracting - Financial Details for New Entrant DCEs 
  
  
• Direct Contracting - Financial Details for Standard DCEs 
  
  
• Understanding the Model Matrix 201
  
  
• Understanding the Model Matrix 101
  
  
• Understanding the Direct Contracting Model

News and Advocacy

• NAACOS letter to Innovation Center makes recommendations on improving Direct Contracting
  
  
• NAACOS letter to the Innovation Center outlines steps to promote value-based care and provides detailed program recommendations
  
  
• NAACOS writes HHS Secretary Becerra on policy priorities for the new administration
  
  
• NAACOS letter calls for changes to Direct Contracting's financial methodology, stopping Geographic option
  
  
• NAACOS Welcomes the First Direct Contracting Entities
  
  
• NAACOS statement on CMMI’s clarity on Direct Contracting’s future
  
  
• NAACOS urges swift action to extend the Next Generation ACO Model and announce plans for the future of the Direct Contracting Model
  
  
• NAACOS calls for changes to Direct Contracting and seeks more information
  
  

• NAACOS Launches Direct Contracting Taskforce

• NAACOS Statement on Direct Contracting Request for Applications
  
  
• NAACOS submits feedback on new Geographic and Professional and Global Options of Direct Contracting Models from the CMS Innovation Center
  
  
• NAACOS released a statement welcoming more options for value-based payment arrangements in the form of Direct Contracting and Primary Care First
  
  
• NAACOS calls for greater transparency in Innovation Center’s work
  
  
• NAACOS submits comments in response to CMS’s Request for Information on Direct Provider Contracting models

 indicates Taskforce/members only resource