CMS cancels Direct Decision Support Model

A model first proposed under the Obama administration to involve outside organizations in engaging sick Medicare beneficiaries about their overall health has now been canceled by CMS.

The goal of the Direct Decision Support (DDS) Model had been to partner with decision support organizations, or DSOs, with help up to 700,000 patients with “preference-sensitive conditions,” such as stable ischemic heart disease or clinically localized prostate cancer. Those non-provider organizations would’ve received a fixed monthly payment for very beneficiary for engaging with those patients on behalf of CMS, with 25 percent of the money held back as an annual performance metrics.

Applications for the DDS Model were collected last year but was never launched. On Feb. 2, the agency officially announced it wouldn’t be testing it due to “operational and technical issues” with its design.

“After careful consideration and review of all available options, CMS determined that the design and operational changes necessary to continue with the DDS Model would be too significant and burdensome for participants, and would require a new solicitation,” the agency said.

While the models had been a sign the past administration at CMS wanted to push models on patient engagement outside of clinical care, the current regime has taken a different path. A similar model to DDS, the Shared Decision Making (SDM) model, had been canceled in November 2017. The issue there, according to CMS, had been a lack of interest among the pool of potential applicants, which was limited to accountable care organizations participating in the Medicare Shared Savings Program (MSSP) or the Next Generation ACO model.