Medicare Direct Contracting: A Threat to Seniors and to Medicare’s Future

In his NRLN President’s message, Bill Kadereit requested reading the transcript of testimony presented on February 2 to a Senate Subcommittee by Dr. Susan Rogers, MD, on Medicare Direct Contracting: A Threat to Seniors and to Medicare’s Future. Click here to read the transcript. Dr. Rogers began her testimony with this statement: “To understand how Direct Contracting works and why it threatens Medicare’s future, it’s important to understand the first wave of Traditional Medicare privatization through Medicare Advantage.”

Kadereit wrote, “We know $20 billion of taxpayer rebate money was used to buy MA vision, hearing, dental, and other benefits denied to 40 million others in original Medicare in 2021; that MA plans cost taxpayers 4% more per enrollee than original Medicare, and now we know Direct Contracting Entities (DCEs) will cost even more and that both original Medicare and MA plans could both be at risk.”

Dr. Rogers began her testimony on Direct Contracting with this opening paragraph: “A majority of seniors and disabled Americans choose Traditional Medicare (TM) over Medicare Advantage (MA) because they value the free choice of providers and the power to manage their own care. However, under the Medicare Direct Contracting (DC) pilot program, millions of beneficiaries who actively chose TM are being automatically enrolled into third-party Direct Contracting Entities (DCEs) without their full knowledge or consent.”

She noted: “If a senior is auto-aligned into a DCE, their only way to remove themselves from the DCE is to change primary care providers.

If you are interested in learning about where CMS (Centers for Medicare and Medicaid) is attempting to drive healthcare for seniors.