January 1, 2019, a health care provider may not be enrolled under the Medicare program under section 1866(j) unless the provider is also a participating provider under the health plan. 2209. Delivery system reform for an enhanced health plan (a) In general For plan years beginning with plan year 2020, the Secretary may utilize innovative payment mechanisms and policies to determine payments for items and services under the health plan. The payment mechanisms and policies under this section may include patient-centered medical home and other care management payments, accountable care organizations, value-based purchasing, bundling of services, differential payment rates, performance or utilization based payments, telehealth, remote patient monitoring, partial capitation, and direct contracting with providers. (b) Requirements for innovative payments The Secretary shall design and implement the payment mechanisms and policies under this section in a manner that— (1) seeks to— (A) improve health outcomes