On June 13, 2018, the Secretary of Health and Human Services (HHS), Alex Azar, responded to recommendations from the Physician-Focused Payment Model Technical Advisory Committee (PTAC) on 12 proposed payment models. The Secretary did not commit to implementing any of the models but indicated particular interest in the two serious illness models proposed by the Coalition to Transform Advanced Care (C-TAC) and the American Academy of Hospice and Palliative Medicine (AAHPM). Staff from the Innovation Center have met with submitters and other stakeholders about both proposed models. The Secretary stated in his response that he agrees with PTAC that the Innovation Center should test a payment model that addresses the care for seriously ill beneficiaries. Of the 12 models reviewed by the Secretary, PTAC recommended four for implementation and four for limited-scale testing.
The Secretary also recommended that future submitters take the following factors into consideration as they develop their proposals:
- HHS seeks models that demonstrate potential for significant impact on the Medicare population in ways where the agency can conduct a robust evaluation.
- Use of proprietary tools or tools that are not already developed in a proposed alternative payment model (APM) is an obstacle to HHS’ testing of the model.
- Providing care in accord with current standards of practice or accelerating adoption of emerging standards of care does not require an APM.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established PTAC to review and assess physician-focused payment models based on stakeholder proposals submitted to the committee. The HHS Secretary is required to review the comments and recommendations submitted by the PTAC and post a detailed response to these recommendations.
The Secretary’s response is available here.
The McDermottPlus PTAC Proposal Tracker is available here.
McDermottPlus presentation on the PTAC proposal process is available here.