DCE Benefits

Direct Contracting is intended to test whether the risk-based payment strategies available under the model align financial incentives and offer model participants (Direct Contracting Entities or DCEs) flexibility in engaging health care providers and patients in care delivery that results in preserving or enhancing quality of care while at the same time reducing the total cost of care. Specifically, Direct Contracting offers:

  • Multiple risk-sharing arrangements
  • Flexible beneficiary alignment options, including enhancements to voluntary alignment relative to existing Medicare initiatives
  • Capitation payment options that vary by risk-sharing arrangement
  • Benefit enhancements and payment rule waivers to improve care coordination and service delivery
  • A focus on complex chronic and seriously ill beneficiaries
  • Options for organizations that have not participated in Medicare FFS previously