Today we answer what a direct contracting entity is in the below infographic.
As healthcare continues to undergo an industry-wide shift toward value-based care (VBC), one new VBC model is poised to have a significant impact: Direct Contracting Entities, or DCEs for short.
Direct Contracting Entities, an experimental type of VBC arrangement, were introduced by the Centers for Medicare and Medicaid Services (CMS) in 2020.
DCEs negotiate per-patient healthcare costs directly with CMS, sharing the risk that those costs will be higher than expected, a loss. They also share the benefit if costs are lower than expected, resulting in a profit.
The arrangement gives providers more discretion over how to implement resources when delivering care. The shared up-side and down-side risks are meant to incentivize better quality care.
Why Are DCEs Important?
DCEs are the latest example of a sign of things to come in healthcare: downside risk becoming increasingly mandatory in most patient-provider relationships. These arrangements offer exciting new opportunities for both reducing costs and improving patient outcomes.
Medical Advantage Can Help
Entering into new care arrangements can be intimidating, but the financial and clinical rewards for doing so are significant. Medical Advantage’s expert team of consultants can help.
For more information or to schedule a free consultation, contact one of our consultants today.