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PTAC Recommends Two Models for Implementation at December 2017 Public Meeting

January 03, 2018

McDermott+Consulting

The Physician-Focused Technical Advisory Committee (PTAC) met December 18-20, 2017, in Washington, DC, to review seven proposed payment models. A vote by PTAC results in one of the following decisions directed to 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 one model for implementation and one model for limited-scale testing. PTAC did not recommend implementation or testing for the five remaining models. The chart below summarizes PTAC’s decisions.

Proposal
SubmitterFinal PTAC Vote
Incident ESRD Clinical Episode Payment Model Renal Physicians Association Recommend for Implementation
Advanced Primary Care Alternative Payment Model (APC-APM) for Delivering Patient-Centered American Academy of Family Physicians Recommend for Limited-Scale Testing
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 New York City Department of Health and Mental Hygiene Not Recommended
Medicare 3 Year Value Payment Demonstration Dr. Zhou Yang Not Recommended
LUGPA APM for Initial Therapy of Newly Diagnosed Organ-Confined Prostate Cancer LUGPA Not Recommended
A Single Bundled Payment for Comprehensive Low-Risk Maternity and Newborn Care Provided by Midwife-Led Practices in Independent Birth Centers that are Clinically Integrated with Physician and Hospital Services Minnesota Birth Center Not Recommended
Annual Wellness Visit Reimbursement for Rural Health Clinics Mercy Accountable Care Organization Not Recommended

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 March 26-28, 2018.

Established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), PTAC is tasked with providing comments and recommendations to CMS on physician payment models. The Committee includes 11 members who are nationally recognized for their expertise in physician-focused payment models and related delivery of care. More information on PTAC is available on their 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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