• 02/25/2022

DCE: Direct Contracting Entities

Recent risk-sharing payment model in Medicare, launched by CMS, to promote value-based and coordinated care.

It differs from ACOs in terms of the requirements and level of risk available (refer to Table 1). Also, CMS would offer monthly Total Care Capitation or Primary Care Capitation (capitated and risk-adjusted) under two models – Professional and Global.

Interoperability is imperative for a DCE to succeed, Why?


Table 1

QHIN: Qualified Health Information network

Network of organizations working together to share data. QHINs will connect directly to each other to ensure interoperability between the networks they represent. By establishing a network of QHINs, TEFCA (Trusted Exchange Framework & Common Agreement) seeks to provide a single “on-ramp” for nationwide connectivity and ensure the integrity and security of data as it is delivered where and when needed.

Interoperability Play

Further Info on QHINs

Examples of QHINs

How will TEFCA work

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