Key Points –
Medicare Direct Contracting Entities is a new way for CMS to pay for covered healthcare costs for those enrolled in Original Medicare. When you join a DCE, you are still enrolled in Original Medicare and can see any provider who accepts Medicare. Medicare DCEs have the option to offer additional benefits and incentives.
Medicare changes every year. Sometimes the changes are relatively small, like covering a new screening test or exam. Sometimes, they are pretty big, like the introduction of Medicare Advantage in 2003 and, more recently, the new Medicare Direct Contracting model.
Medicare Direct Contracting is essentially a new way for the Centers for Medicare and Medicare Services (CMS) to pay for covered healthcare costs. Direct Contracting Entities, or DCEs, are currently available in all but a few states. Depending on where you live, you may already be enrolled in one or have the option to do so.
Because they’re new and not yet well understood, DCEs are causing a lot of confusion and even a little controversy. In this article, we’ll give you the facts about Medicare Direct Contracting, how it affects you, and what’s ahead with the DCE model. 
“Are DCEs going to impact my Medicare policy?” We explain everything you need to know about Direct Contracting Entities and Medicare.
What does DCE stand for health?
August 04, 2022 Corey Redding – Executive Director, CareAllies Accountable Care Solutions, LLC GPDC, DCE, and ACO REACH. These acronyms are all associated with evolving demonstration models being assessed by the Center for Medicare & Medicaid Innovation (the CMS Innovation Center).
GPDC stands for the Global and Professional Direct Contracting It is a voluntary Accountable Care Organization (ACO) model that started on October 1, 2020, and will last until December 31, 2022, when it will be replaced by ACO REACH. In essence, GPDC aims to bring elements of value-based care to Original Medicare beneficiaries.
Medicare beneficiaries keep all the benefits of Original Medicare — including the ability to see any provider they wish. However, they might receive added benefits (such as telehealth) if they choose to see a provider who participates in the GPDC Model. Providers who decide to join in GPDC have two risk-sharing options to select from, as well as reduced administrative burdens.
DCE is an abbreviation that means “Direct Contracting Entity.” This term is simply another way to refer to the ACOs involved in GPDC. For example, CareAllies’ Accountable Care Solutions is a DCE. The providers within a DCE operate under a shared governance structure and work toward high-quality, patient-centered care.
The term DCE will be replaced when the GPDC Model is replaced later this year. Entities that participate in the new model – ACO REACH – will be called REACH ACOs,
ACO REACH is short for Accountable Care Organization Realizing Equity, Access, and Community Health, As of January 1, 2023, ACO REACH will replace the GPDC Model, building upon the feedback and lessons learned from GPDC. Organizations that currently participate in GPDC don’t have to reapply for the ACO REACH Model, as long as they maintain a strong compliance record and agree to the new Model’s requirements.
ACO REACH will focus even more on enabling health equity for underserved populations, ensuring provider and beneficiary representation on governing boards, and promoting transparency. As with GPDC, the Medicare beneficiaries in ACO REACH will keep all their Original Medicare benefits and may have access to additional benefits such as telehealth, care coordination, and home visits after a hospital stay.
Understanding the impact For more than a decade, the CMS Innovation Center has worked to transform health care from fee-for-service reimbursement to more equitable and value-based care delivery and payment models. GPDC and ACO REACH are just two of the newest refinements in a progression that the Innovation Center is committed to continuing over the long term to empower patients, reduce provider burdens, and transform risk-sharing arrangements.
CareAllies is excited to continue being a part of this momentous journey. Demonstration models like GPDC and ACO REACH promise to move the industry closer to a more flexible and collaborative way to create healthier communities and care for our most vulnerable patients.
What are the different types of DCE?
What is Direct Contracting? – Direct Contracting is a voluntary, five-year (plus an optional implementation year) alternative payment model (APM) which leverages components from the Next Generation ACO Model (NGACO), Medicare Advantage (MA), and the private sector and will be the focus of today’s write-up. DC’s goals are to:
- Transform risk-sharing arrangements in Medicare Fee-For-Service (FFS)
- Empower beneficiaries to personally engage in their own care delivery
- Reduce provider burden to meet health care needs effectively
Direct Contracting Entities (DCE) form relationships with two types of providers and/or suppliers: Participant and Preferred Providers. There are two key differences between these relationships. First, beneficiaries can only align to Participant Providers, not Preferred Providers.
Secondly, Participant Providers are required to enter a negotiated payment arrangement with the DCE, while Preferred Providers can elect to receive this negotiated payment or not. Direct Contracting Entities should consider these differences when deciding what relationship to form with which providers.
Direct Contracting contains three types of risk arrangements, only two of which are available to participants today. These arrangements are intended to encourage organizations to take on more downside risk. The two risk options, professional and global, are a 50% and 100% shared savings/losses arrangement, respectively.
- There are three DCE Types, Standard, New Entrant, and High Needs, each of which is eligible with the various risk arrangements.
- The Standard DCE Type is for DCEs with substantial historical claims-based experience serving Medicare FFS.
- This type is for any NGACO organization looking to transition to the DC payment model and projected to be a majority of the applicants.
The New Entrant Type are for DCEs with limited experience delivering care to FFS beneficiaries whereas the High Needs Type are for DCEs that focus on beneficiaries with complex, high needs, including individuals with dually eligible for Medicare and Medicaid, similar to the Seriously Ill Population for the Primary Care First.
| Activity 2 | Date 2 |
|---|---|
| Letter of Intent | December 12, 2019 |
| Application for PY1 Due | July 6, 2020 |
| Performance Year 0 Begins (Implementation Period) | October 1, 2020 |
| Performance Year 1 Begins | April 1, 2021 |
| Performance Period Ends | December 31, 2025 |
Is DCE the same as ACO?
The Key Differences: DCE vs. ACO – DCE vs ACO; both create value in healthcare. They are in essence derivatives from each other. At a glance, they might look like they are just the same but these two entities have a few differences in terms of the following: Payments ACOs are paid through the traditional fee-for-service (FFS) option without capitation.
ACOs are rewarded or penalized based on the service and performance they provide. They are paid or penalized depending on the total cost for a given payment year while DCEs come to terms with the Centers for Medicare & Medicaid Services (CMS) for an agreed-upon monthly payment. Providers DCE allows preferred providers to choose whether or not to receive the negotiated payment.
It compels participant providers to agree to a negotiated payment arrangement. Unlike DCE, ACOs don’t have the ability to negotiate and pay preferred providers their share of the capitation payment. Competition DCEs are incentivized to maintain loyal Medicare beneficiaries and attract new ones.
Seeing as DCE is a pilot program, it has yet to be proved whether it is effective or not. On the other hand, ACOs have long been in the industry and have been proven as a successful CMS program. They have shown great improvements in the healthcare systems and have been a promising value-based organization.
Risks Early adopters and participants have tried, tested, and guaranteed the capacity of ACOs. Some might say that ACO is a safe bet as it has been around for many years. In comparison, DCE has just recently been launched and it is not as recognized as the ACO.
What does DCE mean in nursing?
Model align financial incentives and offer model participants ( Direct Contracting Entities or DCEs) flexibility in engaging health care providers and patients in care delivery that results in preserving or. enhancing quality of care while at the same time reducing the total cost of care.
What is DCE short form for?
DCE: Data Circuit-terminating Equipment – DCE is an abbreviation of “Data Circuit-terminating Equipment”, It is also known as data communications equipment and data carrier equipment, basically, a communication-based device, which works as a communication bridge between the data terminal equipment (DTE) and a data transmission circuit.
- It carries out a variety of tasks, which comprise conversion of signals, coding, line clocking, etc.
- A number of further interfacing electronic equipment possibly will also be essential to join up the data terminal equipment (DTE) into a communication channel or transmission circuit and in the form of starting point of transmission circuit or channel into the DTE.
A crossover cable is supposed to be used in a situation when two devices, that are either DTE or both DCE, required to be linked simultaneously to establish a connection devoid of a modem or a related audiovisual translator between them, such as an Ethernet crossover cable.
What is an example of a DCE?
Data Communications Equipment (DCE) can be classified as equipment that transmits or receives analogue or digital signals through a network. DCE works at the physical layer of the OSI model taking data generated by Data Terminal Equipment (DTE) and converting it into a signal that can then be transmitted over a communications link.
- A common DCE example is a modem which works as a translator of digital and analogue signals.
- DCE may also be responsible for providing timing over a serial link.
- In a complex network which uses directly connected routers to provide serial links, one serial interface of each connection must be configured with a clock rate to provide synchronisation.
A modem is the most common kind of DCE. Other common examples are ISDN adapters, satellites, microwave stations, base stations, and network interface cards.
What is the use of DCE?
DCE includes any device which can be used to gain access to a system over telecommunication lines. The most common forms of DCEs are modems and multiplexers.
What is a DCE and what does DCE stand for?
Data Communications Equipment Data communications equipment (DCE) refers to computer hardware devices used to establish, maintain and terminate communication network sessions between a data source and its destination. DCE is connected to the data terminal equipment (DTE) and data transmission circuit (DTC) to convert transmission signals.
What is DCE management?
DCE Management is a kitchen management enterprise formed to support small and start-up food entrepreneurs. Management of dry, cold and frozen storage will be available to accommodate entrepreneurs’ raw inputs and finished goods for members and non-members of the incubator.
What does DCE mean in government?
Deputy Chief Executive (DCE), Strategy, Governance & Development.
Who is the founder of DCE?
Ramon Winemberg – Founder & Chief Executive Officer – DCE, Incorporated | LinkedIn.
What is a DCE study?
Discrete Choice Experiment (DCE) – YHEC – York Health Economics Consortium A discrete choice experiment is a quantitative method increasingly used in healthcare to elicit preferences from participants (patients, payers, commissioners) without directly asking them to state their preferred options.
- In a DCE participants are typically presented with a series of alternative hypothetical scenarios containing a number of variables or “attributes” (usually ≤5), each of which may have a number of variations or “levels”.
- Participants are asked to state their preferred choice between 2 or 3 competing scenarios, each of which consists of a combination of these attributes/levels.
Typically survey instruments include 5-10 of such choices to be completed. Preferences are revealed without participants explicitly being asked to state their preferred level for each individual attribute. For example, a pharmaceutical company might be interested in determining patient preferences for a painkiller provided either as a tablet or liquid formulation.
- Attributes (and levels) tested in a DCE might consist of “time for painkiller to work” ( 30 minutes), “convenience” (inconvenient, convenient) and “number of repeat doses required” (0, 1-2, ≥3).
- Examples of the use of DCEs in healthcare evaluation include assessment of patient preferences for diagnostic services, clinic configurations or different routes of administration for medicines.
How to cite: Discrete Choice Experiment (DCE), (2016). York; York Health Economics Consortium; 2016. https://yhec.co.uk/glossary/discrete-choice-experiment-dce/
What is the full form of DPC in hospital?
DPC, which is an acronym for ‘ Diagnosis Procedure Combination,’ is a patient classification method developed in Japan for inpatients in the acute phase of illness.
What is difference between DCE and DTE?
DTE stands for Data Terminal Equipment, and DCE stands for Data Communications Equipment. DTE is typically either a dumb terminal or the serial port on a computer/workstation. DCE is typically a modem, DSU/CSU, or other piece of data communications equipment, hence the names.
What does the DSC stand for?
Digital Signature Certificates (DSC) are the digital equivalent (that is electronic format) of physical or paper certificates.
What are the main components of DCE?
There are three aspects to DCE security: authentication, secure communications, and authorization. They are implemented by several services and facilities that together comprise the DCE Security Service.
What is the example of DTE and DCE?
Differences between DCE and DTE –
| DTE | DCE |
|---|---|
| 1. DTE is an abbreviation of ‘Data Terminal Equipment’ or ‘Data Terminating Equipment’ | 1. DCE is an abbreviation of ‘Data Circuit Terminal Equipment’ or ‘Data Communication Equipment’. |
| 2. It is a device that either works as a source and destination. | 2. It is a device that is used for transmitting digital data. |
| 3. This equipment connects through the DCE (Data Communication Equipment) network. | 3. This equipment acts as an intermediary between the two networks of DTE. |
| 4. Its devices produce the data and transfer the data to DCE. | 4. Its devices convert the signals to the transmission medium and introduce it onto the telecommunication or network line. |
| 5. Computers, printers, FAX, and routers are some examples of DTE devices. | 5. Modem, satellites, and ISDN adaptors are some examples of DCE devices. |
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: Difference Between DTE and DCE
What does DCE stand for in marketing?
Key Takeaways –
A digital currency exchanger (DCE) is a person or business that acts as an online market maker and exchanges legal tender and other electronic currencies for electronic currencies, and vice versa, for a commission.Digital currencies operate as self-governed currencies, unlike fiat money, which is legally sanctioned by a government.Most digital currency exchangers (DCE) are privately held businesses, which makes access to financial information and company management troublesome.
What is a DCE and what does DCE stand for?
Data Terminating Equipment (DTE) and Data Communication Equipment (DCE) are used to describe two different hardware groups. The term DTE is used primarily for those devices that display user information. It also includes any devices that store or generate data for the user.
What is DCE in pharmacy?
Discrete choice experiments in pharmacy: a review of the literature – PubMed Objective: Discrete choice experiments (DCEs) have been widely used to elicit patient preferences for various healthcare services and interventions. The aim of our study was to conduct an in-depth scoping review of the literature and provide a current overview of the progressive application of DCEs within the field of pharmacy.
- Methods: Electronic databases (MEDLINE, EMBASE, SCOPUS, ECONLIT) were searched (January 1990-August 2011) to identify published English language studies using DCEs within the pharmacy context.
- Data were abstracted with respect to DCE methodology and application to pharmacy.
- Ey findings: Our search identified 12 studies.
The DCE methodology was utilised to elicit preferences for different aspects of pharmacy products, therapy or services. Preferences were elicited from either patients or pharmacists, with just two studies incorporating the views of both. Most reviewed studies examined preferences for process-related or provider-related aspects with a lesser focus on health outcomes.
Monetary attributes were considered to be important by most patients and pharmacists in the studies reviewed. Logit, probit or multinomial logit models were most commonly employed for estimation. Conclusion: Our study showed that the pharmacy profession has adopted the DCE methodology consistent with the general health DCEs although the number of studies is quite limited.
Future studies need to examine preferences of both patients and providers for particular products or disease-state management services. Incorporation of health outcome attributes in the design, testing for external validity and the incorporation of DCE results in economic evaluation framework to inform pharmacy policy remain important areas for future research.
What is DCE clinical reasoning?
Digital Clinical Experience (DCE) is a digital standardized patient that allows students to practice and refine their assessment skills. Students will replicate patient education, empathy, and communication found in a real life patient interaction. DCE allows students to engage in interactions with their patient that are meaningful and educational.
What does DCE mean in MRI?
Relaxation effect – Diffusible CA reduces the tissue relaxation times T1 and T2. This effect is used to generate positive enhanced T1-weighted images. Studies assessing this effect are commonly termed Dynamic Contrast Enhanced (DCE)- MRI, T1-W DCE or Dynamic Relaxivity MRI,