Action Needed by May 25 to Protect Direct Patient Care


“The Direct Primary Care (DPC) model is burgeoning as patients yearn for quality time with their doctor at an affordable price,” writes Marilyn Singleton, MD, JD in a recent oped.

But can the success of DPC help the Medicare program improve patient access to care while lowering costs?

The Center for Medicare and Medicaid Innovation (CMMI) has issued a Request for Information (RFI) to gather feedback on a new Medicare payment model under development that it calls “DPC.”

Sound promising? Unfortunately reading the RFI brings to mind President Reagan’s warning: “The nine most terrifying words in the English language are: I’m from the government and I’m here to help.”

The title of the RFI itself signals an unfortunate transformation of DPC from Direct Patient Care into what CMS calls, “Direct Provider Contracting.”

The RFI goes on to explain the CMS vision of, “direct provider contracting (DPC), through which CMS would directly contract with Medicare providers.” Obviously this interpretation of “DPC” turns the true meaning of Direct Patient Care on its head.

Earlier this month, AAPS submitted comments in response to the RFI voicing our concerns and suggesting actions CMS could take to meaningfully empower Medicare patients and physicians working together outside of the system.

If you’d like to provide feedback to CMS, comments can be submitted to [email protected] Comments must be received by 11:59pm EDT on May 25, 2018.

For some email apps clicking here will launch a new email message with the address filled in and the below template message copied into the body.

An example of what you might say:

Dear Administrator Verma and CMMI Director Boehler:

As CMS moves forward with testing new payment models, please consider options that permit direct patient payment on terms agreed upon by the physician and patient, not dictated by the federal government.

CMS could, for example, allow Medicare beneficiaries the option of filing a claim for reimbursement for the amount Medicare is willing to pay, or facilitate the use of patient-controlled Health Savings Accounts for direct care.

In addition, “DPC” should not be redefined by CMS to mean “Direct Provider Contracting.” It properly stands for Direct Patient Care and requires mutual agreement between patient and physician about what care is expected and how much it will cost.


Thank you for speaking out!  To read the AAPS comments as submitted, click here.