By Monica E. Oss The Centers for Medicare and Medicaid Services (CMS) surprised me with their recent announcement of plans for direct value-based reimbursement of provider organizations—a direct provider organization contracting (DPC) model for community-based care for Medicare fee-for-service, Medicare Advantage, and Medicaid beneficiaries. The initiative is focused on primary care—"CMS would pay these participating practices a fixed per beneficiary per month (PBPM) payment to cover the primary care services the practice would be expected to furnish under the model, which may include office visits, certain office-based procedures, and other non-visit-based services covered under the Physician Fee Schedule, and flexibility in how otherwise billable…
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