Medicare Advantage and Medicare Direct Contracting Considerations for Health Systems and Medical Groups

It’s the time of year when Joe Namath and other personalities are taking to the airwaves to tell seniors about the benefits of Medicare Advantage (MA) plans. For seniors, choosing between traditional Medicare and MA plans during the annual enrollment period can have a significant financial impact.

The same holds true for health care providers currently in or considering contracting through value-based Medicare payment models. MA plans certainly may offer lucrative value-based payment options to providers. However, the Medicare Direct Contracting (MDC) model can provide enticing opportunities as well.

What’s the best way, then, to allocate precious resources to maximize performance improvement and financial success? As the Centers for Medicare & Medicaid Services (CMS) considers opening a new MDC application window in 2022, the time to start developing a strategy and planning for success is now.

Here are some key considerations for health systems and medical groups as they look to expand their value-based footprint in the Medicare-eligible population through MA or MDC or both.