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PTAC Resources

Telehealth and Alternative Payment Models

PTAC explored telehealth in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs) for its September 2020 public meeting.

Care Coordination and Alternative Payment Models

PTAC explored care coordination in the context of alternative payment models (APMs) and physician-focused payment models (PFPMs) for its June 2021 public meeting.

Charting Future Directions Paper

The Charting Future Directions paper is an ASPE staff paper that offers historical context about PTAC, current opportunities, and future directions for the Committee.

Common Alternative Payment Model (APM) Approaches: Reference Guide

The Common APM Approaches Reference Guide summarizes some major types of payment methodologies that are typically used in APMs.

Review of Proposed Models

Two reports and a set of slides that review the proposed models deliberated and voted on by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) as of December 2019 are available below:


Data

  • Federal Public Data: A Guide for Navigating Publicly Available Files for Those Developing Physician-Focused Payment Models
    This document highlights publicly available data sources that could be used in the development of Physician-Focused Payment Model (PFPM) proposals.

  • Illustrative Data on Medicare Utilization and Reimbursement for Fee-for-Service Beneficiaries with Certain Medical Conditions (PDF and Excel)

    • Table 1A: Medicare Utilization and Reimbursement for Fee-for-Service Beneficiaries Newly Diagnosed with Congestive Heart Failure, Calendar Year 2014- PDF

    • Table 1B: Medicare Utilization and Reimbursement for Fee-for-Service Beneficiaries Ever Diagnosed with Congestive Health Failure, Calendar Year 2015- PDF

    • Table 1C: Medicare Utilization and Reimbursement in the One-Year Period Following Diagnosis Fee-for-Service Beneficiaries with a 2014 Diagnosis of Congestive Heart Failure- PDF

    • Table 2A: Average Total All-cause Medicare Fee-for-Service Spending for Selected Chronic Conditions, 2015- PDF

    • Table 2B: Average All-cause Part A Medicare Fee-for-Service Spending for Selected Chronic Conditions, 2015 (Based on the CMS 5% Limited Data Set) - PDF

    • Table 2C: Average All-cause Part B Medicare Fee-for-Service Spending for Selected Chronic Conditions, 2015 (Based on the CMS 5% Limited Data Set) - PDF

    • Appendix A: CHMS Chronic Conditions Data Warehouse (CCW)- CCW Condition Algorithms (rev. 7/2016) - PDF

    • Excel Workbook - All Tables, Illustrative Data on Medicare Utilization and Reimbursement for Fee-for-Service Beneficiaries with Certain Medical Conditions


Toolkits, Examples of Payment Models, and Additional Resources


Archived Webinars (2016-2017)

Please note that information in these webinars may be outdated. For the most current information, please review the Submit a Proposal page.


To receive updates about upcoming resources and other PTAC news, subscribe to the PTAC email listserv. For past updates, see the archive of prior listserv announcements can be found on the PTAC Listserv Homepage.