Value Proposition of MLTSS Health Plan Participation in CMMI Direct Contracting (DC) Model

On Monday, April 22, 2019, CMMI announced a new type of alternative payment model: Direct Contracting (DC). The DC model is focused on giving participants the ability to take increasing levels of risk for a patient population through flexible payments and benefit enhancements. There are two tracks based on the level of risk and flexibility that CMMI has released information on to date (more information to come on a third track in late 2020 or early 2021):

  • Professional – partial risk arrangement with 50% shared savings/losses and a Primary Care Capitation payment
  • Global – full-risk arrangement with 100% shared savings/losses and option of either a Primary Care Capitation or Total Care Capitation payment

Read the Association’s Value Proposition of MLTSS Health Plan Participation in the CMMI here.