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With the approval of two highly anticipated Covid-19 vaccinations, America has entered into a long-awaited new phase in battling the Covid-19 pandemic: Vaccination. The Pfizer – BioNTech1 Covid-19 vaccine and the Moderna2 Covid-19 Vaccine were both approved for use last week. Thanks to decades-long advances in healthcare infrastructure and technology, we have never been better […]

Program Structure and Features The Medicare Direct Contracting (MDC) Geographic Model, or “Geo”, is the third of three available MDC models released by CMMI. The Geo Model is a population based payment (PBP) model that will offer Direct Contracting Entities (DCEs) the opportunity to assume risk for the total cost of care for Medicare fee-for-service […]

Medicare Direct Contracting (MDC) is a set of mature, capitated payment models for Medicare Fee for Service (FFS), evolved from legacy accountable care models (e.g. Next Generation, Medicare Shared Savings Program), and released by the Centers for Medicare and Medicaid Services (CMS) in November 2019. MDC has recently gone live with its first cohort of […]

Health plans recognize that a successful future requires strategic ties to their provider partners to ensure patient access and high quality care. Payers and providers alike have saluted the Affordable Care Act (ACA) precept that such partnerships involving advanced payment methodologies are beneficial for patients, providing financial incentive to providers and resulting in lower costs […]

The Centers for Medicare and Medicaid Innovation (CMMI) has just announced that non-binding letters of intent (LOI) from health organizations who are serving Medicare beneficiaries in one of 15 different Core Based Statistical Areas (CBSA) around the country and are ready to participate in “Geographic Direct Contracting” must be submitted to CMS by 11:59 p.m. […]

The Center for Medicare and Medicaid Innovation (CMMI) has announced the 51 Direct Contracting Entities (DCEs) selected to participate in the initial 2021 Implementation Period (IP) for the Direct Contracting Model Global and Professional Options. The IP began on October 1, 2020, and will run through March 31, 2021. The first Performance Year (PY) begins […]

As votes trickle in, the potential for a Biden Administration in 2021 creates numerous implications for both payers and providers. Going into the weekend and next week, what are the key considerations with relation to the strategic impacts and opportunities from a potential Biden/Harris win? First, a dose of reality: Hopes for compromise agenda:: […]

In COPE Health Solutions‘ first virtual panel, we discuss with leading experts how health plans are responding to the Covid-19 crisis. Our panelists shared how health plans are pivoting their short and long-term strategies, using data analytics, preparing for the upcoming contracting year, and more. 

Program Structure and Features CMS launched Medicare Direct Contracting (MDC) in 2019, giving providers and payers an opportunity to take risk and manage population health for Medicare fee-for-service (FFS) beneficiaries. Although the program builds on existing features of accountable care organization (ACO) models, payments under MDC will be based on partial or full capitation. To […]

The Covid-19 pandemic has spurred rapid implementation of virtual health across the country. Many providers quickly launched telehealth and remote patient monitoring to free up capacity for Covid-19 surges, manage their chronic and high-risk patients from the safety of their homes, and provide an alternative means to access care for those patients fearful or unable […]