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The Centers for Medicare & Medicaid Services is accepting from eligible entities — including hospitals that employ clinicians, critical access hospitals and rural health clinics — to participate in the Primary Care Initiative’s professional and global direct contracting options in calendar year 2020. Both options offer capitated payment and performance-based shared savings and losses. Participants in the professional option will retain half of any savings and pay back half of any losses to Medicare under the model, while participants in the global option will retain all savings and pay back any losses. The 2020 implementation period will provide an opportunity for direct contracting entities, especially those who have not traditionally provided services to a Medicare fee-for-service population, to conduct outreach for voluntary alignment of beneficiaries to the model. CMS plans to open an application period next spring for entities interested in starting in 2021, the first of five performance years for the model. Prospective applicants who have not already submitted a non-binding to apply must do so by Dec. 10. For more information, see the CMS .