TAMPA, Fla., April 19, 2021 /PRNewswire/ -- Collaborative Health Systems (CHS), a management services organization, announced today the formation of a new Direct Contracting Entity (DCE) available to providers unable to apply to the Global and Professional Direct Contracting (GPDC) Model. The announcement follows a recent development from the Center for Medicare and Medicaid Innovation (CMMI) that it will not accept new applicants for the Model.
The GPDC Model is a set of two voluntary risk-sharing options aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries in Medicare fee-for-service (FFS). By extending its DCE to new providers, CHS removes the administrative and financial burden for its provider partners. With no upfront investment or monthly fees, or downside risk for providers, the DCE becomes accessible for many more providers. Multiple CHS-operated DCEs were approved and have deferred participation to launch with the second cohort of the Model on Jan. 1, 2022.
"The unexpected announcement from CMMI reduces the opportunity for engaged providers to participate in the GPDC Model," said Anthony Valdes, President of Collaborative Health Systems. "It also demonstrates the challenges providers have in keeping up with this rapidly evolving landscape, and it's why CHS is uniquely qualified to help providers navigate the transition from ACO to DCE."
For nearly a decade, CHS has helped healthcare providers navigate and succeed in value-based models such as the Medicare Shared Savings Program (MSSP), the Next Generation ACO Model, Medicare Advantage (MA), and now the GPDC Model. Since 2012, CHS has paid $108 million in shared savings to its physician partners. In addition, for the most recent 2019 MSSP and NextGen Performance Year, CHS-supported ACOs achieved an average quality score of 94.6%, and its providers received $22.3 million in shared savings.
"The GPDC Model offers greater innovations, tools, and resources for providers to further engage Medicare beneficiaries and increase quality of care," said Michael Barrett, Vice President of Strategy and Development for Collaborative Health Systems. "Collaborative Health Systems has the infrastructure and experience from MSSP and the Next Generation ACO Model to help provider partners thrive within the new model."
Medicare ACOs are groups of doctors, hospitals, and other healthcare providers who come together voluntarily to provide coordinated, high-quality care to their Medicare beneficiaries. The MSSP is a permanent program that offers providers and suppliers an opportunity to create an ACO, which agrees to be held accountable for the quality, cost, and experience of care of an assigned Medicare FFS beneficiary population. The Next Generation ACO Model was designed under the CMS Innovation Center to test whether strong financial incentives for ACOs can improve health outcomes and reduce expenditures for Medicare FFS beneficiaries. It is set to sunset at the end of 2021. The GPDC Model was designed by the CMS Innovation Center as the next evolution in risk sharing arrangements to produce value and high-quality healthcare. Provider groups in the Model assume higher levels of financial risk and reward than are available under the MSSP.
Collaborative Health Systems (CHS) is a management services organization that partners with independent primary care physicians as they move to value-based models. Its core belief is that primary care physicians are in the best position to influence the quality and cost of healthcare. CHS provides comprehensive support for its physician partners by providing management services, risk contracting, and population health capabilities, including actionable data and other tools, to deliver care coordination and closure of gaps in care. CHS provides additional services to secure and deliver favorable value-based contracts with commercial and other health plans. CHS manages two Next Generation ACOs, one Direct Contracting entity, eight MSSP ACOs, a Care Transformation Organization, and three Independent Practice Associations. CHS is a wholly owned subsidiary of Centene Corporation. For more information, visit www.CollaborativeHealthSystems.com.
Collaborative Health Systems operates Monday through Friday from 8 a.m. to 5 p.m. ET. For more information, call 866-245-7043.