The Center for Medicare and Medicaid Innovation (CMMI) unveiled 2022 calendar year results for the Direct Contracting Model on Monday.
The Direct Contracting Model is the predecessor to the ACO REACH Model that helps direct contracting entities (DCEs) earn savings. More than three-quarters of those who participated reaped savings, according to a press release from the National Association of ACOs. Just 23% of participants recorded losses.
In 2022, DCEs earned $870 million in gross savings, with gross savings increasing more than seven times between 2021 and 2022, showing the growth in the model. Net savings totaled $484 million, as 93% of savings were generated from the benchmark discount and 7% from shared savings arrangements.
For DCEs that started the program in 2021, they earned 67% higher net savings in total, on average.
Of the 99 model participants, the figures signal a nearly 3% savings rate. The average Total Quality Score was 99.4% across the 91 standard DCEs and 99% across the eight High Needs Population DCEs.
NAACOS President and CEO Clif Gaus said in a statement that direct contracting savings let providers test hybrid payments that “allow for practices to receive population-based payments rather than fee-for-service payments” and does not impose prior authorization.
“These data reaffirm the need to invest in alternative payment models that hold providers accountable for patients’ total cost of care and quality,” said Gaus. “Direct Contracting offers many innovative flexibilities and waivers to allow providers to effectively manage their patients to deliver the right care, in the right setting, at the right time.
Among the top performers was New Jersey-based Vytalize Health, referred to as PT Intermediate, a holding company, on a list distributed by CMMI. Vytalize was one of five standard DCEs, and the only DCE to begin in 2022, to place in the top quartile for cost, quality and patient experience.
The Vytalize platform generated $1,343 in savings per beneficiary.
“Vytalize is fully dedicated to value-based care,” said CEO Faris Ghawi in an interview with Fierce Healthcare. “We work very closely with the independent practices to help them through data, peer-to-peer coaching, clinical services and our tools to help drive savings.”
Ghawi attributes their success to the data it provides doctors at the point of care as well as its close integration with the Vytalize medical team and independent practices. Its reimbursement, he said, incentivizes savings and better health outcomes.
The Direct Contracting Model is designed to coordinate care for patient populations, allowing providers to assume higher levels of financial risk and reward than under the Medicare Shared Savings Program. The program was redesigned as the ACO REACH model in January.
In August, the program was adjusted to reduce the beneficiary alignment minimum for new entrant ACOs from 5,000 to 4,000 as well as to reduce minimums for high needs populations.