Physician-Focused Payment Model Technical Advisory Committee (PTAC) will recommend a primary care-focused alternative payment model developed by the American Academy of Family Physicians (AAFP) be tested by HHS.
The model, called the Advanced Primary Care Alternative Payment Model (APC-APM), centers on “monthly, prospective, risk-adjusted primary care global payments for direct patient care and monthly prospective, population-based payments covering non-face-to-face patient services. Past AAFP president John Meigs Jr., MD, said the proposal for a national model had some common characteristics with the existing Comprehensive Primary Care Plus (CPC+) model in an April interview with HealthExec.
PTAC members voted to recommend the proposal to the HHS Secretary at its Dec. 19 meeting, while adding that some additional refinements are needed on core quality measures and monthly payments.
“I love this model and I love this idea, but it is not ready,” said committee member Len Nichols, PhD. “It should be tested on a scale large enough to reflect its potential value. It's a better model than CPC+, and it's better for our country.”
In response to the vote, AAFP’s current president, Michael Munger, MD, said the model will support small and independent practices, reduce administrative burden and move primary care further away from fee-for-service.
“To be truly successful in improving care and reducing costs, APMs must have a strong primary care foundation,” Munger said in a statement. “The AAFP proposal is an opportunity for CMS to make advanced APMs broadly accessible to Medicare beneficiaries—and to positively affect quality and spending in other parts of the health care system.”
PTAC has also recommend several other models proposed by healthcare organizations and specialty groups for limited testing, including APMs developed by American College of Surgeons and the Icahn School of Medicine at Mount Sinai.
Groups have called on CMS to open up new opportunities in the Advanced APM portion of the Quality Payment Program since the agency canceled two mandatory bundled payment programs which would have qualified for the 5 percent APM bonus in 2018.