The Blog to Transform Advanced Care

Advancing Care through Innovation, Observation and Collaboration.

Today, a panel of experts convened by the U.S. Department of Health and Human Services (HHS) took a major step forward by advancing two alternative payment models designed to support people living with serious and advanced illness. One model was developed by C-TAC and the other by the American Academy of Hospice and Palliative Medicine (AAHPM).

C-TAC is thrilled by the Physician-Focused Payment Model Technical Advisory Committee’s (PTAC) decision to recommend these models. The vote sends C-TAC’s Advanced Care Model (ACM) and AAHPM’s Patient and Caregiver Support for Serious Illness to HHS Secretary Alex Azar for his approval for a funded Medicare payment demonstration.

“With 10,000 Baby Boomers becoming eligible for Medicare every day, many of whom have or will have serious or advanced illness, we must find a way to provide quality care to this population,” said Tom Koutsoumpas, Co-Founder and Co-Chair of C-TAC, during his opening remarks. “C-TAC is honored to stand at the forefront of this exciting opportunity to transform the healthcare system. This is the first step in changing how we care for people most in need in this country.”

The ACM was developed from a broad evidence base of successful programs. It is designed to meet the needs of the growing population living with advanced illness and their families by breaking down silos within the healthcare system, bridging traditional medical and social services, and creating comprehensive care management of an individual’s healthcare needs. If fully implemented, the ACM would affect approximately 25% of Medicare expenditures and support millions of beneficiaries.

Members of PTAC underscored the importance of this population for Medicare. C-TAC is excited to work with HHS and AAHPM to develop a demonstration that best serves this vulnerable community.

“We’ll be better as country for the work [C-TAC and AAHPM] have done,” said Jeffrey Bailet, Executive Vice President at Blue Shield of California and Chairperson of PTAC, during the meeting.

PTAC is an eleven-member panel of experts in healthcare payment models created in 2015 as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA created new ways for Medicare to pay physicians for the care they provide beneficiaries. PTAC receives industry proposals and evaluates them on criteria such as scope, quality, cost, and patient choice and safety.

To read more about C-TAC’s ACM, click here. You can find out more about PTAC here. The video from today’s hearing will be available here.

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