Overview

This session will explore the various contracting techniques that CMS, providers and employers are using to achieve their strategic objectives across both the commercial and Medicare markets. For commercial, we will discuss bundled payments, direct primary care and other contracting models for provider risk. For Medicare, we will focus on CMS's Direct Contracting model and how it fits into the suite of provider options for taking risk. 

At the conclusion of this session, attendees will be able to:- 

• Differentiate between the provider risk options available in the Medicare and commercial spaces 
• Define contracting models such as bundled payments, direct primary care, on-site health clinics, shared savings arrangements, reference-based pricing and network replacement
• Understand CMS’s new Direct Contracting Model and evaluate how it compares to other Medicare models
• Identify strengths and weaknesses, and evaluate the potential financial outcomes of each contracting option
• Consider which risk sharing strategy is best for the needs of an individual organization

Agenda and Speakers

Moderator(s): Brian Sweatman, FSA, MAAA

Presenter(s): James Lucas, ASA, MAAA; Matthew Smith, FSA, MAAA; Brian Sweatman, FSA, MAAA