Castell enters Medicare direct contracting program


Patrick Jones


The U.S. Centers for Medicare and Medicaid Services (CMS) have selected Castell to administer a second Direct Contracting Entity (DCE) in the Medicare Global and Professional Direct Contracting (GPDC) program in 2022. As a DCE in this program, Castell will participate in risk-sharing arrangements aimed at enhancing quality of care and reducing expenditures for Medicare beneficiaries. Castell Accountable Care will serve Medicare beneficiaries in Utah and southern Idaho.

Participant DCEs are able to receive monthly capitated payments for primary care and are responsible for managing the total cost of care. Castell will help coordinate and manage the care of beneficiaries to ensure they are receiving the right care in the right place at the right time through increasing access to preventive and primary care for all beneficiaries, particularly those in underserved communities.

“We are excited to expand the GPDC program to our patients in Utah and Idaho. The incentives put in place by this program will help us accelerate our journey to delivering value-based care,” said Dr. Will Daines, Chief Operating Officer and Medical Director of Clinical Operations for Castell. “Additionally, this program provides us with the ability to reach out to Medicare beneficiaries by offering them benefits not traditionally available to Medicare Fee-For-Service (FFS) beneficiaries. These benefits will help us strengthen our relationship with FFS beneficiaries and better manage their care.”

Castell now operates DCEs in Nevada, Utah, and Idaho. For Castell, moving into the GPDC payment arrangement model will increase the number of beneficiaries in value-based care arrangements under the organization’s management and enable it to use its tools and services to help participant providers better care for more Medicare patients. For Intermountain Healthcare, Castell’s participation as a DCE in the program will continue the system’s transformation into a value-based care health organization. “As the healthcare system as a whole becomes less reliant on fee-for-service payments, we can begin to reimagine the process for delivering primary care to those in our community,” said Daines. “The lessons learned and care processes we put in place in this model will help us continue to innovate and deliver more effective, lower cost care for all beneficiaries in the Intermountain west.”

This press release was provided by Castell Health.