Understanding Direct Contracting Entities (DCE): Another Acronym, Another Opportunity

Toward the end of 2020 CMS announced its new model around Direct Contracting Entities (DCE) which begins its performance year on April 1, 2021. The new payment model aims to reduce healthcare costs while enhancing the quality of care for Medicare Fee For Service beneficiaries. Not a novel idea, but this program has far more skin in the game for providers and much more potential upside for beneficiaries.

Leading up to the roll out and implementation of CMS’ Direct Contracting program, providers and managed care organizations have had a lot of practice with heavily regulated quality and cost programs. In fact, that was one of the criteria CMS used to select the group of 51 Direct Contracting Entity finalists.

Like all government-sponsored programs, Direct Contracting has a lot of moving parts. After I read all the specs, reviewed the financial methodology, and attended most of the webinars, I was reminded of how labor-intensive this is for admin and care management staff. But reducing provider burden is a worthwhile effort that allows them to focus 100% on patient care. I hope this program does provide some relief to clinicians. It couldn’t come a moment too soon. U.S. providers and clinicians are completely burnt out.