macra

PTAC Recommends Models for Implementation and Limited Scale Testing at March 2018 Meeting

March 30, 2018

McDermott+Consulting

The Physician-Focused Technical Advisory Committee (PTAC) met March 26-27, 2017, in Washington, DC, to review four proposed payment models. A vote by PTAC results in one of the following decisions directed to the Centers for Medicare and Medicaid Services (CMS):

  • Not recommended;
  • Recommended for limited-scale testing;
  • Recommended for implementation; or
  • Recommended for implementation as a high priority.

At the recent meeting, PTAC recommended two models for implementation and two models for limited-scale testing.

Path to Model Implementation

CMS will make the final decision on which models to implement. A detailed response to the PTAC recommendations will be posted on the CMS website. Models approved by CMS will be implemented by the Innovation Center. A number of factors, beyond the PTAC recommendation, may influence the agency’s ultimate decision.

  •  MACRA Criteria: Does this model meet the MACRA criteria for an Advanced APM?
  •  Ease of Implementation: How difficult will it be to implement this model?
  •  Overall CMS Strategy: How does this model fit into the overall CMS strategy for APM development?
  •  Timing: What is the capacity and priorities of the agency at the specific time the model is proposed?

PTAC is next scheduled to meet June 14-15, 2018.

Proposals Open for Comment

PTAC is also accepting public comments until April 12, 2018, on two new proposals:

Comments should be sent to the Designated Federal Official for PTAC at PTAC@HHS.gov. Mail can be sent to PTAC c/o Angela Tejeda, ASPE, 200 Independence Ave. SW, Washington, DC 20201.

Six PTAC Reports Sent to the Secretary

PTAC has transmitted its comments and recommendations to the Secretary of Health and Human Services on six proposals for physician-focused payment models that were deliberated and voted on at its December 2017 public meeting:

  •  Advanced Primary Care: A Foundational Alternative Payment Model (APC-APM) for Delivering Patient-Centered, Longitudinal, and Coordinated Care submitted by the American Academy of Family Physicians (AAFP)
  •  Annual Wellness Visit Billing at Rural Health Clinics submitted by Mercy Accountable Care Organization
  •  Incident ESRD Clinical Episode Payment Model submitted by the Renal Physicians Association (RPA)
  •  LUGPA APM for Initial Therapy of Newly Diagnosed Patients with Organ-Confined Prostate Cancer submitted by the Large Urology Group Practice Association (LUGPA)
  •  Medicare 3 Year Value Based Payment Plan (Medicare 3VBPP) submitted by Zhou Yang, PhD, MPH
  •  Multi-Provider, Bundled Episode-of-Care Payment Model for Treatment of Chronic Hepatitis C Virus (HCV) Using Care Coordination by Employed Physicians in Hospital Outpatient Clinics submitted by the New York City Department of Health and Mental Hygiene (NYC DOHMH)

The reports to the Secretary reflect the voting at the December 2017 meeting, the rationale for each recommendation, and additional comments to the Secretary regarding the proposed models. All six reports have been posted on the PTAC website.

The McDermottPlus PTAC Proposal Tracker is available here.

McDermottPlus presentation on the PTAC proposal process is available here.

 


For more information visit the McDermottPlus MACRA Resource Center or contact Sheila Madhani at 202-204-1459, smadhani@mcdermottplus.com.

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