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What We’re Watching: May 28, 2019

GETTING GEOGRAPHIC (WITH DIRECT CONTRACTING)

The Centers for Medicare & Medicaid Services is in the process of defining the major tentpoles of the Geographic option within its upcoming Direct Contracting model and has called for stakeholder feedback by the end of this week. The Geographic option would assign a patient population of at least 75,000 Medicare fee-for-service beneficiaries within a targeted region to an entity that is willing to accept 100% up- and down-side risk for spending and quality outcomes.

What we’re saying

The Direct Contracting model is the most ambitious model yet from CMS, representing the bipartisan focus on shifting risk from public payers to private entities. Premier plans to submit comments to ensure provider-led applicants are given priority within the model and that CMS establishes rules for model overlap that give precedence to entities that take responsibility for total cost of care.

MORE SUPPORT FOR MOMS

A new study from the Georgetown University Health Policy Institute found that states that expanded Medicaid have experienced 1.6 fewer maternal deaths per 100,000 women compared with those that did not. The same study also shows that the infant death rate within states that expanded their Medicaid program fell by more than 50 percent between 2010 and 2016.

What we’re saying: In April, Premier launched the Bundle of Joy™ campaign to raise the bar on the quality and cost of care for mothers and babies. As part of this campaign, we’re working with several hospitals in Medicaid expansion states and plan to announce new efforts in the near future. Stay tuned.

IN CASE YOU MISSED IT

What We’re Watching is a weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members. Check out last week's update.

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