CMS Announces New Care Delivery Models


Centers for Medicare & Medicaid Services (CMS) has announced two new care delivery models intended to improve patient engagement and decision-making: (i) the Shared Decision Making Model, and (ii) the Direct Decision Support Model. The Shared Decision Making Model allows Medicare beneficiaries to work with their clinicians to choose the best treatment plans and surgeries. Clinicians can participate in the model if they are currently part of the Medicare Shared Savings Program or a Next Generation Accountable-Care Organization. The Direct Decision Support Model relies on engaging beneficiaries about their health outside of the clinical setting. CMS will partner with up to seven Decision Support Organizations (DSO), organizations that provide health management and decision support services. Each DSO will provide decision support for a core set of preference-sensitive conditions, in addition to proposing a broader range of acute and chronic conditions. The model will encourage the use of decision aids such as pamphlets or brochures that offer treatment options for particular conditions. Both models can be used by Medicare patients with six conditions: stable ischemic heart disease; hip or knee osteoarthritis; herniated disk or spinal stenosis; clinically localized prostate cancer and benign prostate hyperplasia. Organizations and providers interested in both models can apply until March 5, 2017.

Related Practices:   Healthcare Law

Related Attorney:   Keith J. Roberts