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Advanced Illness Care Payment Proposals Move to HHS Secretary

A panel of experts convened by the U.S. Department of Health & Human Services (HHS) formally recommended to the HHS Secretary Alex Azar two payment proposals, one submitted by C-TAC and the other by the American Academy of Hospice and Palliative Medicine (AAHPM).

“We applaud this historic recommendation and its potential impact to provide high-quality care to the sickest and most vulnerable members in our society,” said Tom Koutsoumpas, co-chair and co-founder of C-TAC. “We’re excited to be working with AAHPM on this process.”

The Physician-focused Payment Technical Advisory Committee (PTAC) recommended both models for limited-scale testing to Secretary Azar. The PTAC underscored that the need for high-quality advanced illness care services for Medicare beneficiaries stating: “Moreover, we recommend that testing proceed with the highest possible priority… the need for palliative care services for Medicare beneficiaries is urgent and that such care can only be effectively provided with changes to Medicare payment policy such as those proposed in these two models.”

Due to the complementary nature of the proposals, PTAC advised that C-TAC and AAHPM collaboratively work with the Centers for Medicare & Medicaid Services. Both organizations have been excited to work together to better assist HHS in quickly moving to implement a new palliative care payment model that can accommodate a continuum of interested providers ranging from large health systems to small practices.

“We’re committed to working with CMS, C-TAC, and all stakeholders to find the best solutions for our seriously ill patients and those who care for them,” said AAHPM chief medical officer Joe Rotella, MD MBA HMDC FAAHPM. “They’re counting on us.”

C-TAC’s Advanced Care Model is designed to break down silos among professional groups, bridge traditional medical and social services, and create comprehensive care management of a person’s healthcare needs.

C-TAC recently released a report that reviews successful advanced illness management programs and the barriers they face. Payment continues to be the biggest barrier to scaling and sustaining these programs. Both models are designed to test a new funding stream to expand access for the Medicare population to these types of programs.

Read PTAC’s recommendation here.

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