The New Capitation – What Goes Around, Comes Around!

Tucker Arensberg, P.C.
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On April 23, 2018, CMS issued a request for information on direct provider contracting models.  In that request, (attached hereto as a PDF), CMS stated as follows:

“Under a primary care-focused DPC model, CMS could enter into arrangements with primary care practices under which 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…”

I believe this used to be called capitation, although way back then it was called PMPM (per member per month).  Comments are due by May 25, 2018.  I wonder if Helen Hunt’s character in “As Good As It Gets” would still like to submit a comment?

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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