You may not have heard much about it, but in the Medicare system, there's now something

called direct contracting.

It was started under Trump and it's continued under Biden and it allows private physician

practices, hospitals or insurance companies to contract it directly with Medicare and

get a set amount of money over the year.

That contrasts with traditional Medicare in which healthcare providers build Medicare directly

for services.

The stated point of direct contracting is to experiment with new models that would save

money and improve care.

But it's critics warn that it's a runaway scam that is being exploited by venture capital

and private equity firms and that it'll lead to worse care on the long run based on private

equity's poor record of delivering care in other settings.

The project in question was designed by Adam Boller, who was previously a dorm mate of Jared

Kushner's and also the founder of Landmark Health, a VC-backed healthcare company.

He was brought in to run the Center for Medicare and Medicaid Innovation under Trump and as

he was designing this new model, Career Staff became concerned about conflicts of interest.

When a calendar alert went out to staff in May 2019, reading, quote, discussion with landmark

on the direct contracting model, Career Staff were appalled.

I obtained a group text in which they commiserated with one another and expressed their disgust

over the corporate influence.

This is a family podcast so I'll edit the messages, but a sampling.

This stuff is so effing gross wrote one.

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