Frequently Asked Questions

A Medicare Direct Entity (MDE) is a group of doctors, hospitals, and other healthcare providers who agree to work together to keep patients healthy. Members of America’s MDE agree to work together to see that patients get the right care at the right time. We will coordinate your patients’ care according to their individual medical needs and treatment choices. MDEs work to reduce duplicate tests and duplicate paperwork that unnecessarily waste time and inflate the cost of care.

America’s MDE is a clinically integrated network for physicians, allowing them rapid access to medical treatment for patients. With the ever-changing healthcare reimbursement system and methods of delivering healthcare, now is the perfect time to join America’s MDE. America’s MDE provides the breadth, scale and integration of providers necessary to significantly enhance the quality of care and reduce the cost of care that payers are seeking to achieve.

By partnering with America’s MDE you’ll have the tools necessary to demonstrate to payers the value of your practice. Collaborating with physicians and other providers of care is essential to achieve the clinical quality and efficiency necessary to be successful in the future of healthcare.

CMMI designed the Direct Contracting Model in an effort to improve quality and reduce cost, while incentivizing innovation.  The Direct Contracting Model is value-based, where providers are compensated for the quality of their care, measured by patient health outcomes. In this model, providers are compensated for effectively managing the health of their patients. This value-based care delivery model promotes preventive, holistic, and patient-focused care and facilitates coordination of patient care across all providers.

The Centers for Medicare and Medicaid Innovation’s (CMMI) Direct Contracting is designed to move away from fee-for-service (FFS) reimbursement models. With FFS models, providers are financially rewarded for quantity over quality. In a value-based model, providers are compensated for the quality of their care, measured by patient health outcomes. Moreover, providers are compensated for effectively managing the health of their patients.

The value-based care delivery models promote preventive, holistic, and patient-focused care and facilitates coordination of patient care across all providers. Value-based care is expected to improve our healthcare system by making us healthier and reducing the overall cost of care. With value-based care:

  • Providers are rewarded for the quality of care provided over the quantity of services rendered. Providers who can demonstrate efficiency and effectiveness in their care benefit the most. .
  • This includes incentives for coordinating care with the medical team, thereby providing preventative care and treatments.
  • It aims to reduce administrative burdens and requirements, and encourage providers to enter risk-bearing arrangements.
  • It’s designed to put the patient to participate at the center of the healthcare system, involving them in their own care planning and sharing in the decision making process.

For more information and answers to Frequently Asked Questions (FAQs) on the Direct Contracting Model established by CMMI, visit The Centers for Medicare and Medicaid website at https://www.cms.gov/newsroom/fact-sheets/direct-contracting.