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Is the Direct Contracting Model Similar to Medicare Advantage? Francois de Brantes Has An Answer
In this third of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.
Below you'll find a brief excerpt from the transcript of our recent podcast interview with François de Brantes. They have edited for clarity and length.
Is the Direct Contracting Model similar to Medicare Advantage?
The mechanics are similar. The difference is that in Medicare Advantage, Medicare contracts with a Medicare managed care organization, and that Medicare managed care organization can continue to pay 100% of the care for the beneficiaries that enroll in the MA plan fee for service. The chassis of Medicare Advantage plans are a fee-for-service adjudication process.
Now, some of them are fairly innovative in the way that they create the reimbursements with the providers in their network. But a lot of them simply continue to pay a fee for service. So yes, it's like Medicare Advantage in the sense that you're pre-paying an entity a fixed amount for a beneficiary.
The difference is that you're now relying on a provider organization or, you know, some affiliate of a provider organization, to contract with providers, hopefully in a different way.
Emerging Therapies Committee at UC Davis Hits the Accelerator Not the Brake | AMCP 2024
April 18th 2024After the onboarding of cell and gene therapy bogged using normal pharmacy and therapeutics (P&T) committee procedures, UC Davis Health set up an emerging therapeutics committee to streamline and speed up the process of delivery expensive cell and gene therapies.
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DC Roundtable: Patrick Cooney of The Federal Group Drops the Latest on PBM Legislation in Washington
April 11th 2024In this episode of "DC Roundtable," Peter Wehrwein, managing editor of Managed Healthcare Executive, spoke with Patrick Cooney, president of The Federal Group, a lobbying and strategic planning firm in Washington, D.C., about recent developments in Washington concerning PBMs.
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2024 Emerging Leaders in Healthcare — Submit For a Chance to Be Featured in MHE's August Issue
April 18th 2024MHE Editors are seeking diverse healthcare professionals from different backgrounds and healthcare sectors, with individual interests. Eligible candidates are early or mid-career leaders with less than 10 years of experience. Award winners will enjoy complimentary passes to the PBMI Annual National Meeting in Orlando, Florida, from Sept. 4-6. Additional perks include a feature in our August issue, a subscription to MHE and more!
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