December 13, 2018

PTAC Recommends Oncology Alternative Payment Model

At its December 10, 2018, public meeting, the Physician-Focused Payment Model Technical Advisory Committee (PTAC) voted unanimously to recommend the proposed “Making Accountable Sustainable Oncology Networks (MASON)” alternative payment model (APM) to the secretary of Health and Human Service (HHS) for his consideration.

This recommendation was further augmented by a new second stage in the recommendation phase of the PTAC deliberation and voting. This new phase would be triggered only if PTAC voted in favor of recommending an APM, with the second vote resulting in further guidance regarding the nature of the recommendation. In this case, the PTAC recommended further developing and implementing the proposal as a payment model. Other options for recommendation included testing and inclusion in a current Center for Medicare & Medicaid Innovation (CMMI) proposal.

PTAC is statutorily mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and is tasked with reviewing proposals for physician-focused payment models, preparing comments and recommendations on such proposals and explaining whether they meet criteria established by the HHS secretary. These criteria include value over volume, flexibility, quality and cost, payment methodology, scope, ability to be evaluated, integration and care coordination, patient choice, patient safety and health information technology.

PTAC will continue to evaluate proposed models to determine if they meet the secretary’s approval criteria for limited-scale testing, implementation or implementation with a high priority, or if the criteria lead the secretary to not recommend its proposals. PTAC will meet again in March 2019.