AAPS: Is CMS “DPC” model headed wrong direction?

Source: AAPSOnline.org | May 2018

CMS Seeks Comments on Medicare “DPC Model”

Notes from the CMS RFI

From the Apr 25 RFI (https://tinyurl.com/ydfx4ncw), it is apparent that a CMS DPC is a type of Accountable Care Organization (ACO). Under the CMS contract, the “providers and suppliers” would “agree to be accountable for the cost and quality of care of a defined beneficiary population.” They are offered the ability to take on “two-sided financial risk.” One difference is that beneficiaries would “voluntarily enroll” in a DPC practice. They might not even know they are currently in an ACO. The practice would have “the opportunity to earn performance-based incentives for total cost of care and quality.”

HHS Secretary Alex Azar indicated, in a speech to the American Hospital Association, that he considers DPC one of the “value-based care models,” along with ACOs, that CMS wants to facilitate. He may also, some providers hope, ease self-referral restrictions (the Stark Law) that they claim keep physicians and hospitals from building ACOs (tinyurl.com/ycxnwy9m).

SOURCE: https://aapsonline.org/aaps-news-may-2018-non-participation/

By Marilyn M. Singleton, MD, JD | Article Source: Patients and Physicians Unite: You Have Nothing to Lose but Your Chains

MAY 16, 2018 @ 12:51pm EST – In an entertainment venue called the “Escape Room,” participants are locked inside a themed adventure room, and they must figure out how to escape. Themes include prisons, KGB interrogation, and hostage situations. Perhaps a new theme could be ObamaCare. Despite a large majority of Americans reporting healthcare as their number one concern, Congress does not have the political appetite for a serious assessment of the Affordable Care Act. It’s time for Congress to say, “ACA and its ‘fixes’ are not working; cut our losses and move in a different direction.” New proposals should focus on reducing the cost of pharmaceuticals and medical services rather than shifting costs from one entity to another via mandated insurance benefits and government subsidies. (Read Full Article Here: Link)

Volume 74, no. 5 

The Center for Medicare and Medicaid Services (CMS) has sent out a Request for Information (RFI) concerning a new project called DPC. This stands for Direct Provider Contracting—not Direct Primary Care or Direct Patient Care, the growing type of practices that work for patients, not third  parties. There are now about 770 such practices, the majority of them completely opted out of Medicare. CMS wants them back, offering to pay “providers,” with as little administrative hassle “as necessary.”

Read Full May 2018 Newsletter at: https://aapsonline.org/aaps-news-may-2018-non-participation/


SOURCE: https://aapsonline.org/patients-and-physicians-unite-you-have-nothing-to-lose-but-your-chains/


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