Direct Contracting opportunity for MA plans

The Center for Medicare and Medicaid Innovation (CMMI) in 2020 introduced a new Medicare fee-for-service (FFS) risk program, Direct Contracting (DC), which is open to participation by Medicare Advantage (MA) plans. This white paper discusses how MA plans are well positioned to leverage their existing provider relationships, care management, and risk score coding programs to become successful Direct Contracting entities (DCEs). The paper gives historical context to CMS’s allowing of organizations to take financial risk for Medicare FFS patients. It also defines DCEs and how they generate savings, explains why should an MA plan become one, and considers possible deadlines for a model start date of Jan. 1, 2022.