June 14, 2022

PTAC Discusses Total Cost of Care Models

The Physician Focused Payment Model Technical Advisory Committee (PTAC) discussed total cost of care (TCOC) models during its quarterly public meeting June 7–8. Population-based TCOC models are a type of alternative payment model in which payment is determined by a composite measure made up of costs and utilization for all covered medical services delivered to an individual or group.

PTAC continued its work from last quarter’s public meeting by sharing best practices for implementing TCOC models, lessons learned for improvement, the importance of data collection for risk scoring, and how to enhance coordination between primary and specialty care providers. This meeting had increased focus on assessing best practices of TCOC models.

PTAC members shared their experience and perspectives through case studies that demonstrate how these models can be successfully implemented, but also pointed out where there is room for improvement to prepare for the transition from fee-for-service care to TCOC models. The American College of Radiology® (ACR®) expects to see continued discussion and inclusion of TCOC within CMS models.

PTAC is an independent federal advisory committee that makes recommendations to the secretary of the U.S. Department of Health and Human Services on stakeholder-submitted physician-focused Medicare payment models and related topics. PTAC’s next public meeting will take place Sept. 19–20.

For more information or if you have questions, please contact Christina Berry, ACR Team Lead Economic Policy or Kimberly Greck, ACR Economic Policy Analyst.