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