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Risk Bearing Entity Requirements: An Introduction

Providers and provider organizations are increasingly contracting with payors to manage specific patient pools and diseases on a risk basis. They are taking new and increasing financial risk to better align with payors’...more

CMS’ Latest Innovation Model – The Making Care Primary (MCP) Model Includes Focus on Social Determinants of Health

On June 8, 2023, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary primary care model, the Making Care Primary (MCP) Model. Highlights include the following: The MCP Model will run for 10.5...more

Antitrust: DOJ Scuttles ACO Guidance, Unsettles Ground under Provider Joint Contracting Models

On Friday, February 6, 2023, the Department of Justice (DOJ) announced the withdrawal of the 2011 Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings...more

Value-Based Programs: CMS Redesigns Global and Professional Direct Contracting Model and Renames it “ACO REACH"

The Centers for Medicare and Medicaid Services (CMS) recently announced a redesign of the Global and Professional Direct Contracting Model (the GPDC Model) and renamed the GPDC Model the ACO REACH Model. (“REACH” stands for...more

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