Proposals
PTAC has received the following proposals for physician-focused payment models from members of the public. Complete proposals are generally added to the website within one week of receipt. Each proposal is open for three weeks of public comment and considered by a preliminary review team (PRT) prior to deliberation and voting at a public PTAC meeting. Information related to each proposal will be added to the website when available.
- The "Medical Neighborhood" Advanced Alternative Payment Model (AAPM) (Revised Version) submitted by the American College of Physicians (ACP) and the National Committee for Quality Assurance (NCQA) — comment period closed March 20, 2020.
- Patient-Centered Oncology Payment Model (PCOP) submitted by the American Society of Clinical Oncology (ASCO) — comment period closed February 18, 2020.
- Remote specialists and experts on demand improving care and saving costs (Revised version) submitted by Eitan Sobel, MD — comment period closed January 3, 2020.
- Remote specialists and experts on demand improving care and saving costs submitted by Eitan Sobel, MD — comment period closed October 1, 2019.
- Eye Care Emergency Department Avoidance (EyEDA) submitted by the University of Massachusetts Medical School — comment period closed July 29, 2019.
- Oncology Care Model 2.0 submitted by the Community Oncology Alliance — comment period closed July 1, 2019.
- Patient-Centered Asthma Care Payment submitted by the American College of Allergy, Asthma & Immunology — comment period closed June 12, 2019.
- ACCESS Telemedicine: An Alternative Healthcare Delivery Model for Rural Cerebral Emergencies submitted by the University of New Mexico Health Sciences Center (UNMHSC) — comment period closed March 22, 2019.
- The "Medical Neighborhood" Advanced Alternative Payment Model (AAPM) submitted by the American College of Physicians (ACP) and the National Committee for Quality Assurance (NCQA) — comment period closed January 4, 2019.
- CMS Support of Wound Care in Private Outpatient Therapy Clinics: Measuring the Effectiveness of Physical or Occupational Therapy Intervention as the Primary Means of Managing Wounds in Medicare Recipients submitted by Upstream Rehabilitation — comment period closed January 4, 2019. (Please note that this is a revised and resubmitted proposal. For information related to the original proposal, please also see the CMS Support of Wound Care proposal submitted by BenchMark Rehab Partners, a division of Upstream Rehabilitation, below).
- CAPABLE Provider Focused Payment Model submitted by the Johns Hopkins School of Nursing and the Stanford Clinical Excellence Research Center — comment period closed December 12, 2018.
- Bundled Payment for All Inclusive Outpatient Wound Care Services in Non Hospital Based Setting submitted by Seha Medical and Wound Care — comment period closed November 27, 2018.
- Acute Unscheduled Care Model (AUCM): Enhancing Appropriate Admissions submitted by the American College of Emergency Physicians — comment period closed July 23, 2018.
- Bundled PCI Services in a Non-hospital Cath Lab (Bundled PCI Services) submitted by Clearwater Cardiovascular and Interventional Consultants, MD, PA (CCC) — comment period closed June 29, 2018.
- An innovative model for primary care office payment submitted by Jean Antonucci, MD — comment period closed April 20, 2018.
- APM for Improved Quality and Cost in Providing Home Hemodialysis to Geriatric Patients Residing in Skilled Nursing Facilities submitted by Dialyze Direct — comment period closed April 12, 2018.
- Comprehensive Care Physician Payment Model (CCP-PM) submitted by the University of Chicago Medicine — comment period closed April 12, 2018.
- Making Accountable Sustainable Oncology Networks (MASON) submitted by Innovative Oncology Business Solutions, Inc. (IOBS) — comment period closed March 26, 2018.
- CMS Support of Wound Care in Private Outpatient Therapy Clinics: Measuring the Effectiveness of Physical or Occupational Therapy Intervention as the Primary Means of Managing Wounds in Medicare Recipients submitted by BenchMark Rehab Partners (a division of Upstream Rehabilitation) — comment period closed November 30, 2017.
- Home Hospitalization: An Alternative Payment Model for Delivering Acute Care in the Home submitted by Personalized Recovery Care, LLC — comment period closed November 30, 2017.
- Acute Unscheduled Care Model (AUCM): Enhancing Appropriate Admissions submitted by American College of Emergency Physicians — comment period closed November 20, 2017.
- The Patient-Centered Headache Care Payment (PCHCP) submitted by American Academy of Neurology — comment period closed November 20, 2017.
- Advanced Care Model (ACM) Service Delivery and Advanced Alternative Payment Model submitted by Coalition to Transform Advanced Care — comment period closed November 1, 2017.
- Intensive Care Management in Skilled Nursing Facility Alternative Payment Model (ICM SNF APM) submitted by Avera Health — comment period closed October 6, 2017.
- Annual Wellness Visit Billing at Rural Health Clinics submitted by Mercy Accountable Care Organization — comment period closed September 29, 2017.
- Patient and Caregiver Support for Serious Illness submitted by American Academy of Hospice and Palliative Medicine (AAHPM) — comment period closed September 29, 2017.
- LUGPA APM for Initial Therapy of Newly Diagnosed Patients with Organ-Confined Prostate Cancer submitted by LUGPA — comment period closed August 8, 2017.
- Medicare 3 Year Value Based Payment Plan (Medicare 3VBPP) submitted by Zhou Yang, PhD — comment period closed August 1, 2017.
- A Single Bundled Payment for Comprehensive Low-Risk Maternity and Newborn Care Provided by Independent Midwife-Led Birth Center Practices that Are Clinically Integrated with Physician and Hospital Services submitted by the Minnesota Birth Center — comment period closed July 20, 2017.
- Incident ESRD Clinical Episode Payment Model submitted by the Renal Physicians Association (RPA) — comment period closed June 26, 2017.
- 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 New York City Department of Health and Mental Hygiene (NYC DOHMH) — comment period closed June 14, 2017.
- “HaH Plus” (Hospital at Home Plus) Provider-Focused Payment Model submitted by the Icahn School of Medicine at Mount Sinai — comment period closed May 31, 2017.
- 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 — comment period closed May 18, 2017.
- Oncology Bundled Payment Program Using CNA-Guided Care submitted by Hackensack Meridian Health and Cota Inc. — comment period closed April 27, 2017.
- Advanced Care Model (ACM) Service Delivery and Advanced Alternative Payment Model submitted by Coalition to Transform Advanced Care — comment period closed March 6, 2017.
- The Comprehensive Colonoscopy Advanced Alternative Payment Model for Colorectal Cancer Screening, Diagnosis and Surveillance submitted by the Digestive Health Network, Inc. — comment period closed January 25, 2017.
- Project Sonar submitted by the Illinois Gastroenterology Group and SonarMD, LLC. — comment period closed January 20, 2017.
- The COPD and Asthma Monitoring Project (CAMP) submitted by Pulmonary Medicine, Infectious Disease and Critical Care Consultants Medical Group Inc. (PMA) — comment period closed January 12, 2017.
- The ACS-Brandeis Advanced APM submitted by the American College of Surgeons — comment period closed January 12, 2017.
Letters of Intent Received
Active
- Establishment of Accountable Care Organizations (ACO) or similar Risk Bearing Entities (RBE), submitted by Paradigm Provider Partners, Inc. [2024]
Expired
- Establishment of Accountable Care Organizations (ACO) or Similar Risk Bearing Entities (RBE) submitted by Paradigm Provider Partners, Inc. [2023]
- Physiatrist Led Post-Acute Micro-Bundle Model submitted by Edward Burnetta, MD, LLC
- Patient- Centered Oncology Payment Model (PCOP) [2017] submitted by the American Society of Clinical Oncology (ASCO)
- Episodic Payments for Radiation Oncology submitted by the American College of Radiation Oncology (ACRO)
- Radiation Oncology Total Cost of Care Physician Focused Payment Model submitted by the American Society for Radiation Oncology (ASTRO)
- APM for Retinal Disease submitted by US Retina
- Medical Cardiology Super Bundle submitted by Cynapse Health, Inc.
- CAPG Medicare Alternative Payment Model – Full Risk submitted by CAPG
- Total Joint Arthroplasty Advanced APM submitted by the American Association of Hip and Knee Surgeons (AAHKS)
- Physician Focused Payment Model (PFPM) for Comprehensive Care of Chronic Kidney Disease (CKD) Patients submitted by the National Kidney Foundation
- Tech-enabled Emergency & Acute Medicine at SNF bedside (TEAM SNF) to Reduce Unplanned Hospital Admissions Alternative Payment Model (APM) submitted by Call9 Emergency Medical. Withdrawn on 4/13/2018.
- Tech-enabled Emergency & Acute Medicine at SNF bedside (TEAM SNF) to Reduce Unplanned Hospital Admissions Advanced Alternative Payment Model (AAPM) submitted by Call9 Emergency Medical
- The Patient-Centered Headache Care Payment (PCHCP) submitted by American Academy of Neurology
- Medical Neighborhood APM [2018] submitted by the American College of Physicians (ACP) and the National Committee for Quality Assurance (NCQA)
- Skilled Residential Homes for the "Medically Homeless" submitted by Sun Medical Care, P.C.
Reports to the Secretary
- Encouraging Rural Participation in Population-Based Total Cost of Care (PB-TCOC) Models - PTAC held a theme-based discussion focused on encouraging rural participation in population-based total cost of care (PB-TCOC) models as its September 2023 public meeting. View a recording of the September 2023 discussion.
- Improving Management of Care Transitions in Population-Based Total Cost of Care (PB-TCOC) Models - PTAC held a theme-based discussion focused on improving management of care transitions in PB-TCOC Models as its June 2023 public meeting. View a recording of the June 2023 discussion.
- Improving Care Delivery and Specialty Integration in Population-Based Total Cost of Care Models – PTAC held a theme-based discussion focused on improving specialist integration within PB-TCOC Models and physician-focused payment models as its March 2023 public meeting. View a recording of the March 2023 discussion.
- Population-Based Total Cost of Care and Alternative Payment Models – PTAC held a series of theme-based discussions throughout 2022 on the role PB-TCOC Models can play in optimizing health care delivery and value-based transformation in the context of alternative payment models and physician-focused payment models. View the recordings:
- SDOH and Equity and Alternative Payment Models – PTAC held a theme-based discussion on optimizing efforts to address social determinants of health (SDOH) and equity in the context of Alternative Payment Models and physician-focused payment models at its September 2021 meeting. View a recording of the September 2021 discussion.
- Care Coordination and Alternative Payment Models – PTAC held a theme-based meeting related to the role of care coordination in optimizing health care delivery and value-based transformation in the context of Alternative Payment Models (APMs) and physician-focused payment models (PFPMs) at its June 2021 meeting. View a recording of the June 2021 discussion.
- Telehealth and Alternative Payment Models – PTAC held a theme-based discussion related to the role of telehealth in optimizing health care delivery and value-based transformation in the context of Alternative Payment Models (APMs) and physician-focused payment models (PFPMs) at its September and December 2020 meetings. View the recordings:
- The "Medical Neighborhood" Advanced Alternative Payment Model (AAPM) (Revised Version) submitted by the American College of Physicians (ACP) and the National Committee for Quality Assurance (NCQA). The comment period closed March 20, 2020. PTAC deliberated and voted to recommend testing this proposal as specified in PTAC comments to inform payment model development at its meeting on September 15, 2020. View a recording of the voting and deliberation process for the ACP and NCQA.
View the Secretary's response to the ACP and NCQA. - Patient-Centered Oncology Payment Model (PCOP) submitted by the American Society of Clinical Oncology (ASCO). The comment period closed February 18, 2020. PTAC deliberated and voted to refer this proposal for other attention by HHS at its meeting on September 15, 2020. View a recording of the voting and deliberation process for ASCO.
View the Secretary's response to the ASCO. - Eye Care Emergency Department Avoidance (EyEDA) submitted by University of Massachusetts Medical School. The comment period closed July 29, 2019. PTAC deliberated and voted to not recommend this proposal at its meeting on June 22, 2020. View a recording of the voting and deliberation process for the University of Massachusetts Medical School.
View the Secretary's response to the University of Massachusetts Medical School. - Patient-Centered Asthma Care Payment submitted by the American College of Allergy, Asthma & Immunology. The comment period closed June 12, 2019. PTAC deliberated and voted to refer this proposal for other attention at its meeting on June 22, 2020. View a recording of the voting and deliberation process for the American College of Allergy, Asthma, and Immunology.
View the Secretary's response to the American College of Allergy, Asthma, and Immunology. - ACCESS Telemedicine: An Alternative Healthcare Delivery Model for Rural Cerebral Emergencies submitted by the University of New Mexico Health Sciences Center (UNMHSC). The comment period closed March 22, 2019. PTAC deliberated and voted to recommend further developing and implementing the proposal as a payment model at its meeting on September 16, 2019. View a recording of the voting and deliberation process for UNMHSC.
View the Secretary's response to UNMHSC. - CAPABLE Provider Focused Payment Model submitted by the Johns Hopkins School of Nursing and the Stanford Clinical Excellence Research Center. The comment period closed December 12, 2018. PTAC deliberated and voted to recommend testing the proposal to inform payment model development at its meeting on June 17, 2019. View a recording of the voting and deliberation process for the Johns Hopkins School of Nursing and Stanford Clinical Excellence Research Center.
View the Secretary's response to the Johns Hopkins School of Nursing and Stanford Clinical Excellence Research Center. - CMS Support of Wound Care in Private Outpatient Therapy Clinics: Measuring the Effectiveness of Physical or Occupational Therapy Intervention as the Primary Means of Managing Wounds in Medicare Recipients submitted by Upstream Rehabilitation. The comment period closed January 4, 2019. PTAC deliberated and voted to not recommend this proposal at its meeting on March 11, 2019. View a recording of the voting and deliberation process for Upstream Rehabilitation.
View the Secretary's response to Upstream Rehabilitation. - Bundled Payment for All Inclusive Outpatient Wound Care Services in Non Hospital Based Setting submitted by Seha Medical and Wound Care. The comment period closed November 27, 2018. PTAC deliberated and voted to not recommend this proposal at its meeting on March 11, 2019. View a recording of the voting and deliberation process for Seha Medical and Wound Care.
View the Secretary's response to Seha Medical and Wound Care. - Making Accountable Sustainable Oncology Networks (MASON) submitted by Innovative Oncology Business Solutions, Inc. (IOBS). The comment period closed March 26, 2018. PTAC deliberated and voted to recommend this proposal for further development and implementation at its meeting on December 10, 2018. View a recording of the voting and deliberation process for IOBS.
View the Secretary's response to IOBS. - Acute Unscheduled Care Model (AUCM): Enhancing Appropriate Admissions submitted by the American College of Emergency Physicians. The comment period closed July 23, 2018. PTAC deliberated and voted to recommend this proposal for implementation at its meeting on September 6, 2018. View a recording of the voting and deliberation process for the American College of Emergency Physicians.
View the Secretary's response to the American College of Emergency Physicians. - Comprehensive Care Physician Payment Model submitted by the University of Chicago Medicine. The comment period closed April 12, 2018. PTAC deliberated and voted to recommend this proposal for limited-scale testing at its meeting on September 7, 2018. View a recording of the voting and deliberation process for the University of Chicago Medicine.
View the Secretary's response to the University of Chicago Medicine. - An Innovative Model for Primary Care Office Payment submitted by Jean Antonucci, MD. The comment period closed April 20, 2018. PTAC deliberated and voted to recommend this proposal for limited-scale testing at its meeting on September 6, 2018. View a recording of the voting and deliberation process for Jean Antonucci, MD.
View the Secretary's response to Jean Antonucci, MD. - Alternative Payment Model for Improved Quality and Cost in Providing Home Hemodialysis to Geriatric Patients Residing in Skilled Nursing Facilities submitted by Dialyze Direct. The comment period closed April 12, 2018. PTAC deliberated and voted to recommend this proposal for attention at its meeting on September 6, 2018. View a recording of the voting and deliberation process for Dialyze Direct.
View the Secretary's response to Dialyze Direct. - Joint Statement with CMS Administrator Seema Verma. To read the statements CMS Administrator Seema Verma and PTAC Chair Dr. Jeffrey Bailet made regarding their meeting on June 14, 2018, click here.
- Intensive Care Management in Skilled Nursing Facility Alternative Payment Model (ICM SNF APM) submitted by Avera Health. The comment period closed October 6, 2017. PTAC deliberated and voted to recommend this proposal for implementation at its meeting on March 27, 2018. View a recording of the voting and deliberation process for Avera Health.
View the Secretary's response to Avera Health. - Home Hospitalization: An Alternative Payment Model for Delivering Acute Care in the Home submitted by Personalized Recovery Care, LLC. The comment period closed November 30, 2017. PTAC deliberated and voted to recommend this proposal for implementation at its meeting on March 26, 2018. View a recording of the voting and deliberation process for Personalized Recovery Care, LLC.
View the Secretary's response to Personalized Recovery Care, LLC. - Patient and Caregiver Support for Serious Illness submitted by American Academy of Hospice and Palliative Medicine (AAHPM). The comment period closed September 29, 2017. PTAC deliberated and voted to recommend this proposal for limited-scale testing at its meeting on March 26, 2018. View a recording of the voting and deliberation process for AAHPM.
View the Secretary's response to AAHPM. - Advanced Care Model (ACM) Service Delivery and Advanced Alternative Payment Model submitted by Coalition to Transform Advanced Care. The comment period closed November 1, 2017. PTAC deliberated and voted to recommend this proposal for limited-scale testing at its meeting on March 26, 2018. View a recording of the voting and deliberation process for the Coalition to Transform Advanced Care.
View the Secretary's response to the Coalition for Transform Advanced Care. - Incident ESRD Clinical Episode Payment Model submitted by the Renal Physicians Association (RPA). The comment period closed June 26, 2017. PTAC deliberated and voted to recommend this proposal for implementation at its meeting on December 18, 2017. View a recording of the voting and deliberation process for the RPA.
View the Secretary's response to the RPA. - 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 New York City Department of Health and Mental Hygiene (NYC DOHMH). The comment period closed June 14, 2017. PTAC deliberated and voted to not recommend this proposal at its meeting on December 18, 2017. View a recording of the voting and deliberation process for NYC DOHMH.
View the Secretary's response to NYC DOHMH. - Medicare 3 Year Value Based Payment Plan (Medicare 3VBPP) submitted by Zhou Yang, PhD, MPH. The comment period closed August 1, 2017. PTAC concluded that the criteria for PFPMs established by the Secretary are not applicable to this proposal at its meeting on December 18, 2017. View a recording of the voting and deliberation process for Zhou Yang, PhD, MPH.
View the Secretary's response to Zhou Yang, PhD, MPH. - Annual Wellness Visit Billing at Rural Health Clinics submitted by Mercy Accountable Care Organization. The comment period closed September 29, 2017. PTAC concluded that the criteria for PFPMs established by the Secretary are not applicable to this proposal at its meeting on December 18, 2017. View a recording of the voting and deliberation process for Mercy Accountable Care Organization.
View the Secretary's response to Mercy Accountable Care Organization. - 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. The comment period closed May 18, 2017. PTAC deliberated and voted to recommend this proposal for limited-scale testing at its meeting on December 19, 2017. View a recording of the voting and deliberation process for the American Academy of Family Physicians.
View the Secretary's response to the American Academy of Family Physicians. - LUGPA APM for Initial Therapy of Newly Diagnosed Patients with Organ-Confined Prostate Cancer submitted by LUGPA. The comment period closed August 8, 2017. PTAC deliberated and voted to not recommend this proposal at its meeting on December 19, 2017. View a recording of the voting and deliberation process for LUGPA.
View the Secretary's response to LUGPA. - Oncology Bundled Payment Program Using CNA-Guided Care submitted by Hackensack Meridian Health and Cota Inc. The comment period closed April 27, 2017. PTAC deliberated and voted to recommend this proposal for limited-scale testing at its meeting on September 8, 2017. View a recording of the voting and deliberation process for Hackensack Meridian Health and Cota Inc.
View the Secretary's response to Hackensack Meridian Health and Cota Inc. - "HaH Plus” (Hospital at Home Plus) Provider-Focused Payment Model submitted by the Icahn School of Medicine at Mount Sinai. The comment period closed May 31, 2017. PTAC deliberated and voted to recommend this proposal for implementation at its meeting on September 7, 2017. To view a recording of the voting and deliberation process, View a recording of the voting and deliberation process for the Icahn School of Medicine at Mount Sinai.
View the Secretary's response to the Icahn School of Medicine at Mount Sinai. - PTAC Letter to the Secretary on Lessons Learned
- Project Sonar submitted by the Illinois Gastroenterology Group and SonarMD, LLC. The comment period closed January 20, 2017. PTAC deliberated and voted to recommend this proposal for limited-scale testing at its meeting on April 10, 2017. View a recording of the voting and deliberation process for the Illinois Gastroenterology Group and SonarMD, LLC.
View the Secretary's response to the Illinois Gastroenterology Group and SonarMD, LLC. - The COPD and Asthma Monitoring Project submitted by Pulmonary Medicine, Infectious Disease and Critical Care Consultants Medical Group Inc. of Sacramento, California (PMA). The comment period closed January 12, 2017. PTAC deliberated and voted not to recommend this proposal at its meeting on April 11, 2017. View a recording of the voting and deliberation process for PMA.
View the Secretary's response to PMA. - The ACS-Brandeis Advanced APM submitted by the American College of Surgeons. The comment period closed January 12, 2017. PTAC deliberated and voted to recommend this proposal for limited-scale testing at its meeting on April 11, 2017. View a recording of the voting and deliberation process for the American College of Surgeons.
View the Secretary's response to the American College of Surgeons.