Federal regulators are considering the future of the Direct Contracting program and an announcement could come soon, unnerving some provider groups.
The concerned groups are urging the Centers for Medicare and Medicaid Services to tweak but not toss out the Global and Professional Direct Contracting part of the program.
The push comes after a groundswell of progressive lawmakers have called on the administration to stop the program, saying it transforms traditional Medicare into Medicare Advantage and that profit-driven participants could hurt patient care. But some Direct Contracting advocates fear the domino effects of political influence on Center for Medicare and Medicaid Innovation demonstrations.
A CMS spokesperson said the agency is actively listening to feedback about GPDC and the comments are "invaluable" as it considers the future of the model. CMS will provide more information about the fate of the model soon, the spokesperson added.
Provider associations including America's Physician Groups, the National Association of Accountable Care Organizations and group purchasing organization Premier are reaching out to each other and their members to lobby CMS to keep the GPDC program intact. The groups plan to send a letter to Health and Human Services Department Secretary Xavier Becerra early this week, and said they've heard an announcement could come as early as Tuesday.
"Direct Contracting is a needed high-risk, value-based payment model designed to improve patient care. Please keep the model and make adjustments as needed or else we risk taking a step backward on work that provides patients with higher quality of care at a lower cost," the letter reads.
The Direct Contracting program is part of CMS' push towards value-based care arrangements. The initiative has taken on new meaning recently, as the agency in October unveiled a goal to bring all Medicare beneficiaries into value-based care by 2030.
GPDC builds off CMMI's previous ACO models, offering higher levels of risk and greater opportunities for reward. Fifty-three entities took part in the 2021 performance year, and another set began on Jan. 1, though CMMI has not yet announced the 2022 participants and paused new applications.