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.
- Telehealth Report to the Secretary
- Environmental Scan on Telehealth in the Context of APMs and PFPMs
- Telehealth Environmental Scan Supplement
- Telehealth September 2020 Summary Report
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:
- Slides of Proposed Models Voted on by PTAC
- Report on Proposed Models Voted on PTAC
- Report on PTAC Voting Patterns and Comments on Proposals
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
Alternative Payment Model Design Toolkit by Center for Medicare & Medicaid Innovation
Link to the Quality Payment Program (QPP) Website
This website includes more information on the Quality Payment Program (QPP) including a description of the program, information on participation, a detailed implementation timeline, and a description of how QPP will change Medicare payments.-
Examples of Health Care Payment Models Being Used in the Public and Private Sectors by Social & Scientific Systems, Inc.
Information from the Specialty Payment Models Opportunities and Design Initiative by MITRE
RAND’s Specialty Payment Model Opportunities and Assessment Oncology Simulation Report
This report describes the results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS).RAND’s Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report
This report describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS).
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 tab.
Webinars hosted by the Physician-Focused Payment Model Technical Advisory Committee
“How to Submit a Proposal to PTAC: Clarifications and Tips for Submitters” hosted by PTAC Members Harold Miller and Robert Berenson, MD on February 27, 2017 from 2:00-3:00 pm ET.
The slides for "How to Submit a Proposal to PTAC: Clarifications and Tips for Submitters” webinar are available."How to Submit a Proposal to the Physician-Focused Payment Model Technical Advisory Committee (PTAC)" hosted by PTAC Members Harold Miller and Dr. Kavita Patel
The slides for "How to Submit a Proposal to the Physician-Focused Payment Model Technical Advisory Committee (PTAC)" webinar are available."Overview of the Physician-Focused Payment Model Technical Advisory Committee (PTAC)" hosted by PTAC Chair Dr. Jeffrey Bailet, Vice Chair Elizabeth Mitchell, and Member Robert Berenson, MD.
The slides for "Overview of the Physician-Focused Payment Model Technical Advisory Committee (PTAC)" webinar are available.
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.