May 31, 2018 • 27M

CMS Proposes Direct Provider Contracting: A Conversation with Mara McDermott (May 30th)

 
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David Introcaso, Ph.D.
Podcast interviews with health policy experts on timely subjects. The Healthcare Policy Podcast website features audio interviews with healthcare policy experts on timely topics. An online public forum routinely presenting expert healthcare policy analysis and comment is lacking. While other healthcare policy website programming exists, these typically present vested interest viewpoints or do not combine informed policy analysis with political insight or acumen. Since healthcare policy issues are typically complex, clear, reasoned, dispassionate discussion is required. These podcasts will attempt to fill this void. Among other topics this podcast will address: •Implementation of the Affordable Care Act •Other federal Medicare and state Medicaid health care issues •Federal health care regulatory oversight, moreover CMS and the FDA •Healthcare research •Private sector healthcare delivery reforms including access, reimbursement and quality issues •Public health issues including the social determinates of health Listeners are welcomed to share their program comments and suggest programming ideas. Comments made by the interviewees are strictly their own and do not represent those of their affiliated organization/s.
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This past week public comments were due in response to a CMS Request for Proposal (RFI) that would potentially lead to the agency fielding a Medicare a direct primary care (DPC) demonstration.  The demo would pay Medicare physicians directly a predetermined fixed per-beneficiary-per-month fee to provide primary care services to participating beneficiaries.  The demo would try to replicate private, commercial DPC contracts physicians have with individuals or through self-insured employers.  

During this 27 minute conversation Ms. McDermott discusses, in part, both the potential positives and pitfalls should CMS field a DPC demonstration, whether the model would qualify as an Alternative Payment Model (APM) and whether fielding a DPC model would move the Medicare program closer to premium support.

Ms. Mara McDermott is currently Vice President at McDermott + Consulting, a subsidiary of the DC-based law firm McDermott Will and Emory.   (Ms. McDermott is no relation to the McDermott partner.)  Previously, Ms. McDermott was employed as Senior Vice President of Federal Affairs at America's Physician Groups (formerly the California Association of Physician Groups, CAPG).  Previously still, Ms McDermott was counsel in the health care industry at a firm in Washington, DC.  Ms. McDermott received her JD with high honors from George Washington School of Law, her MPH from George Washington University and her BA from the University of California at Davis.  (Listeners may recall Ms. McDermott discussed the proposed MACRA rule via a June 14, 2016 podcast.)

The DPC RFI is at: https://innovation.cms.gov/Files/x/dpc-rfi.pdf. 

For more on Qliance, the former DPC provider group based in Seattle mentioned during this discussion go to: https://www.seattletimes.com/business/qliance-closes-after-10-year-effort-at-new-approach-to-basic-medical-care/. 

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