Evolent Provides Input to CMMI on Direct Contracting Payment Models

May 30, 2019

In late April 2019, the CMS Center for Medicare and Medicaid Innovation (CMMI) announced its long-awaited Direct Contracting payment models, which encourage primary care providers to take on two-sided risk. While some details of the program remain unclear, Evolent Health offered the center input on these models, including a set of principles that we believe should guide the program. 

These principles include:

  • Incentivize and give primacy to full-risk, total-cost-of-care models.
  • Ensure sufficient flexibility within the payment rate to support administrative costs and creative payment incentive arrangements between Direct Contracting Entities and their participating and preferred providers. 
  • Provide strong tools and incentives for providers and beneficiaries to form high-value Direct Contracting networks.
  • Provide a sustainable benchmarking methodology that considers organizations’ prior experience in risk and incentivizes both value and efficiency.
  • Provide a stable and consistent risk adjustment methodology.  
  • Ensure predictability and stability for organizations assuming significant risk. 

For details, read the full letter to Adam Boehler, CMS Deputy Administrator for Innovation & Quality and CMMI Director.

Learn More About Direct Contracting

Find additional insights in these Evolent Knowledge Center resources. 

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