The Geographic Direct Contracting Model (also known as “Geo”) was a new payment and service delivery model considered by the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center). The Model would have tested whether a geographic-based approach to care delivery and value-based care can improve health and reduce costs for Medicare beneficiaries across an entire geographic region.
Geo was built on lessons the CMS Innovation Center learned from prior Medicare shared savings initiatives, including the Medicare Shared Savings Program and the Next Generation ACO Model, as well as innovative approaches from Medicare Advantage, Medicaid Managed Care, and commercial health risk-sharing arrangements. Geo would have required participants to take full risk with 100 percent shared savings / shared losses, with risk corridors, for Medicare Parts A and B services for Medicare fee-for-service beneficiaries in a defined target region. Geo would have been tested over a six-year period in four to ten regions with two three-year Model Agreement Periods.
Direct Contracting Entities (DCEs) in Geo would have assumed financial risk in return for enhanced flexibilities, making it possible for these entities to offer Medicare beneficiaries an increased focus on care coordination through care delivery innovation. The additional tools and flexibilities available to DCEs would have included preferred provider networks, care coordination and clinical management, and payment integrity and medical review. Beneficiaries would have maintained all of their Original Medicare benefits including access to all Medicare enrolled providers and all existing appeal rights under Original Medicare. The unique, geographic focus of the Model would have allowed DCEs to make investments in communities and build relationships based on their knowledge of a community’s specific local needs.
- Geographic Direct Contracting: A Powerful Opportunity for Population Health (Blog Post)
- Geographic Direct Contracting Model Request for Applications (RFA) (PDF)
- Geographic Direct Contracting Model Data Book (XLS) | Geographic Direct Contracting Data Book Instructions (PDF)
- Geographic Direct Contracting Model Proposed Discount Tool (XLS) | Geographic Direct Contracting Proposed Discount Tool Instructions (PDF)
- Geographic Direct Contracting Model Letter of Interest (LOI) (PDF)
- Geographic Direct Contracting Model Fact Sheet (PDF)
- Geographic Direct Contracting Model Press Release
- Geographic Population-based Payment Request for Information (PDF)