RE: Direct provider contracting (DPC) between payers and primary care or multi-specialty groups to inform potential testing of a DPC model within the Medicare fee-for-service (FFS) program.
CMS strategies to improve care and reduce cost should be viewed from the perspective of the whole health 'system.' The most important strategy, shown to have worked in the US and around the world, is access to high quality primary care. There are two reasons this is lacking in the US-
Thus the primary goal for fixing the US health care system must be to reverse these trends. Current policy (e.g., MACRA) has focused on the micro process ('the trees') rather than the macro environment ('the forest') and because of this has been ineffective. The proposed DPC model has the potential to achieve this, by solving several large system problems:
These measures will vastly increase the attractiveness of primary care, and thus increase access to high quality primary care.