Clinical and Payment Models
Below you will find the clinical and payment models that guide C-TAC's vision for the delivery of high-quality, person-centered care to all those living with Advanced Illness.
The Advanced Care Model is a proven service delivery model and proposed new advanced alternative payment model (AAPM) to improve quality and cost outcomes for advanced illness beneficiaries. Today, many individuals with advanced illness receive care that is fragmented, uncoordinated, or inadequate to meet their growing needs and personal wishes. The ACM is specifically designed to meet these needs by “breaking down a range of silos between ‘curative’ and palliative care, between professional groups to foster interdisciplinary practice, and between traditional medical and social services” (IOM Report: Dying in America). The ACM AAPM payment can operate as a stand-alone APM and or in conjunction with existing APMs to ensure all Medicare FFS beneficiaries can access the needed ACM services. Furthermore, the ACM supports primary care and/or specialty provider participation. If implemented fully, the ACM would provide accountability for 25% of Medicare expenditures and engages with almost all members of the care delivery system.
The Coalition to Transform Advanced Care (C-TAC) and the AHIP Foundation have released the findings of the clinical phase of the Advanced Care Project. The Report highlights a framework of clinical best practices that will guide the development of effective care models for those living with advanced illness and their families.
This paper outlines the opportunities presented by C-TAC's Advanced Care Model (currently under review at the HHS) as a framework for stakeholders (including health care providers, plans, and community-based organizations) as they wade through the plethora of new practices, policy options, and payment models for addressing advanced illness in a more holistic and patient-centered way.