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

September 11, 2018

McDermott+Consulting

The Physician-Focused Technical Advisory Committee (PTAC) met September 6-7, 2018, in Washington, DC, to review four proposed payment models. At the recent meeting, PTAC recommended one model for implementation, two models for limited-scale testing and one for a new category referred to as, “recommended for attention.”

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?

As was noted during a recent Congressional hearing, to the frustration of many stakeholders and even some PTAC members, CMS has yet to implement any models recommended by PTAC. In comments made during the September PTAC meeting, Health and Human Services Secretary Alex Azar indicated that the CMS Innovation Center would soon be releasing new models, some of which could be mandatory. He also stated that, “models advanced by PTAC have significantly influenced models we have in the works.”

PTAC is next scheduled to meet December 10-11, 2018.

* * * * *

The Medicare Access and CHIP Reauthorization Act (MACRA) established the PTAC to provide comments and recommendations to the Secretary of Health and Human Services on physician payment models. There are 11 members on the committee.  Additional information is available here.

The McDermottPlus PTAC Proposal Tracker is available here.

McDermottPlus presentation on the PTAC proposal process is available here.

 


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

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