Direct Provider Contracting Models - Request for Information

As a follow-up to the Center for Medicare and Medicaid Innovation's New Direction Request for Information (RFI), the Centers for Medicare & Medicaid Services (CMS) is seeking broad input on direct provider contracting (DPC) between payers and primary care or multi-specialty groups to inform potential testing of a DPC model within the Medicare fee-for-service (FFS) program (Medicare Parts A and B), Medicare Advantage program (Medicare Part C), and Medicaid.

A DPC model would aim to enhance the beneficiary-physician relationship by providing a platform for physician group practices to provide flexible, accessible, and high quality care to beneficiaries that have actively chosen this type of care model.

The public is encouraged to provide feedback on their experiences with, and perspectives on, DPC and how CMS can use DPC models to reduce expenditures and preserve or enhance the quality of care for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries.

In the Request for Information on Direct Provider Contracting Models, commenters are requested to provide responses to questions related to certain design features of a model, such as:

  • Provider/State participation
  • Beneficiary participation
  • Payment
  • General model design
  • Program integrity and beneficiary protections
  • Existing CMS initiatives

Please submit your comments to the CMS Innovation Center at DPC@cms.hhs.gov through 11:59pm EDT May 25, 2018.

Additional Information