FACACLASSIC

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HHS - 2559 - Physician-Focused Payment Model Technical Advisory Committee - Statutory (Congress Created)

GENERAL INFORMATION

Committee Name	Physician-Focused Payment Model Technical Advisory Committee	Agency Name	Department of Health and Human Services
Fiscal Year	2025	Committee Number	2559
Original Establishment Date	1/5/2016	Committee Status	Chartered
Actual Termination Date		Committee URL	https://aspe.hhs.gov/ptac-physician-focused-pay...
Actual Merged Date		Presidential Appointments*	No
New Committee This FY	No	Max Number of Members*	11
Terminated This FY	No	Designated Fed Officer Position Title*	DFO
Merged This FY		Designated Federal Officer Prefix
Current Charter Date	1/5/2016	Designated Federal Officer First Name*	Marsha
Date Of Renewal Charter		Designated Federal Officer Middle Name
Projected Termination Date		Designated Federal Officer Last Name*	Clarke
Exempt From Renewal*	Yes	Designated Federal Officer Suffix
Specific Termination Authority		Designated Federal Officer Phone*	(202) 875-0938
Establishment Authority*	Statutory (Congress Created)	Designated Federal Officer Fax*	202-401-7589
Specific Establishment Authority*	42 U.S.C. §1395ee(c)(1)	Designated Federal Officer Email*	marsha.clarke@hhs.gov
Effective Date Of Authority*	4/16/2015
Exempt From EO 13875 Discretionary Cmte	Not Applicable
Committee Type*	Continuing
Presidential*	No
Committee Function*	National Policy Issue Advisory Board

RECOMMENDATION/JUSTIFICATIONS

Agency Recommendation*	Continue
Legislation to Terminate Required	Not Applicable
Legislation Status	Not Applicable
How does cmte accomplish its purpose?*	The establishing statute requires the Physician-Focused Payment Model Technical Advisory Committee (PTAC) to review physician-focused payment model (PFPM) proposals submitted by individuals and stakeholder entities and make comments and recommendations to the Secretary of Health and Human Services (HHS) regarding the extent to which such models meet criteria established by the Secretary. In FY24, the Committee delivered comments to the Secretary on 2 theme-based discussions based on common themes in prior proposals. As proposals are submitted, the Committee will continue to review proposals and send comments and recommendations to the Secretary in future fiscal years on an ongoing basis.
How is membership balanced?*	The establishing statute requires that the Comptroller General of the United States appoint PTAC members. The membership of the Committee shall include individuals with national recognition for their expertise in physician-focused payment models and related delivery of care under the Medicare program. No more than five members of the Committee shall be providers of services or suppliers, or representatives of providers of services or suppliers. The Secretary, or designee, shall appoint two members to serve as Co-Chairpersons. A member of the Committee shall not be an employee of the Federal Government.
How frequent & relevant are cmte mtgs?*	The number of PTAC meetings per year are influenced by the number of proposals that PTAC receives from individual and stakeholder entities or by the topics related to the submitted proposals. PTAC aims and is scheduled to meet quarterly.
Why advice can't be obtained elsewhere?*	The establishing statute requires PTAC, whose membership must include individuals with national recognition for their expertise in PFPMs and related delivery of care, to review PFPM proposals submitted by individuals and stakeholder entities and make comments and recommendations to the Secretary regarding the extent to which such models meet criteria established by the Secretary.
Why close or partially close meetings?	Not Applicable/All meetings are open to the public.
Recommendation Remarks	PTAC members who reside locally, as per federal travel regulations, are only reimbursed local travel expenses (e.g., mileage and parking). They do not receive a per diem reimbursement. This is why some PTAC members' pay plan is listed as "Other". The designation for all members is listed as "Ex Officio" due to the absence of an "Other" category. It has been determined that PTAC members are neither special government employees nor representatives. Cost calculations vary from prior years. Contracts are included under payments to consultants if the contract included technical support. Performance measures also vary from prior years. Performance measures include cumulative totals for the life of PTAC as of FY24.

PERFORMANCE MEASURES

Outcome Improvement To Health Or Safety*	Yes	Action Reorganize Priorities*	No
Outcome Trust In Government	Yes	Action Reallocate Resources	No
Outcome Major Policy Changes	Yes	Action Issued New Regulations	No
Outcome Advance In Scientific Research	No	Action Proposed Legislation	No
Outcome Effective Grant Making	No	Action Approved Grants Or Other Payments	No
Outcome Improved Service Delivery	Yes	Action Other	No
Outcome Increased Customer Satisfaction	Yes	Action Comment	N/A
Outcome Implement Laws/Reg Requirements	Yes	Grants Review*	No
Outcome Other	No	Number Of Grants Reviewed	0
Outcome Comment		Number Of Grants Recommended	0
Cost Savings*	Unable to Determine	Dollar Value Of Grants Recommended	$0.00
Cost Savings Comment	Cost savings may depend upon how many PFPM proposals PTAC reviews, how many proposal related meetings they have, and how many public meetings they have in a fiscal year. Since PTAC's annual allotment has stayed the same from 2016 and has not increased with inflation, cost savings are more difficult at this time.	Grants Review Comment
Number Of Recommendations*	35	Access Contact Designated Fed. Officer*	Yes
Number Of Recommendations Comment	In FY 24, PTAC delivered comments and recommendations to the secretary on 2 topics related to prior proposals: Improving Management of Care Transitions in Population-based Total Cost of Care Models; Encouraging Rural Participation in Population-based Total Cost of Care Models In FY 23, PTAC delivered comments and recommendations to the secretary on 2 topics related to prior proposals: Optimizing Population-Based Total Cost of Care Models in the Context of APMs & PFPMs; Improving Care Delivery & Integrating Specialty Care in Population-based Models. In FY 22, PTAC delivered comments and recommendations to the secretary on 1 topic related to prior proposals: Social Determinants of Health & Equity. In FY 21, PTAC delivered comments and recommendations to the Secretary on 2 PFPM proposals and 2 topics related to prior proposals: Telehealth and Care Coordination. In FY 20, PTAC delivered comments and recommendations to the Secretary on 3 PFPM proposals. In FY 19, PTAC delivered comments and recommendations to the Secretary on 8 PFPM proposals. In FY 18, PTAC delivered comments and recommendations to the Secretary on 12 PFPM proposals. In FY 17, PTAC delivered comments and recommendations to the Secretary on 3 PFPM proposals.	Access Agency Website	Yes
% of Recs Fully Implemented*	21.43%	Access Committee Website	Yes
% of Recs Fully Implemented Comment	As of FY 24, PTAC has delivered comments and recommendations to the Secretary on 28 PFPM proposals and 3 topics related to prior PFPM proposals. PTAC did not recommend 6 proposals and determined the Secretary’s criteria are not applicable to 2 proposals. PTAC recommended 3 proposals for attention, 8 for limited-scale testing, 3 for testing to inform payment model development, 1 for further development and implementation as a payment model, and 5 for implementation. The Secretary has responded to PTAC’s comments and recommendations on 28 of these proposals. The Secretarial responses did not commit to implementation or testing of any of the proposed PFPMs as recommended by PTAC, and development and implementation takes time.	Access GSA FACA Website	Yes
% of Recs Partially Implemented*	71.43%	Access Publications	Yes
% of Recs Partially Implemented Comment	The Secretarial responses for many of the proposals reflect interest in exploring how proposed ideas might inform model development and/or a desire to continue to engage stakeholders. HHS leaders have also publicly acknowledged that aspects of proposals submitted to and reviewed by PTAC have influenced models put forth by CMMI. In Liz Fowler's remarks to PTAC in March and June 2024, CMMI Director Liz Fowler stated, "Prior PTAC submissions have influenced the design of several of our prior models on Primary Care First, which was influenced by AAFP and the University of Chicago submissions;, the Oncology Care Model and its successor, the Enhancing Oncology Model, both influenced by submissions from Hackensack Meridian Health and COA and ASCO, and then our Kidney Care Choices Model, which was heavily influenced by the Renal Physician Associates." In December 2022, Liz Fowler mentioned working with PTAC on a common goal and that they are using PTAC's platform to reach out to physician groups to get input on very specific ideas (specialty strategy and incorporating equity into models). In 2019, HHS announced payment and care delivery models in primary care and kidney care. Specifically, when CMMI unveiled a set of new payment models as part of its Primary Cares Initiative in April 2019, the announcement materials acknowledged PTAC for its influence on the models’ development, also recognizing the contributions of four proposal submitters. PTAC recommendations can also influence CMS policy beyond affecting new CMMI models. At the September 2021 public meeting, Deputy Secretary, Andrea Palm spoke on HHS' pursuit of health equity and improved health care delivery systems including thoughtfully designed Alternative Payment Models and payment policy. She stated that CMMI is committed to working with physicians and other health care leaders, patient groups, researchers, and other stakeholders, to drive meaningful change and make the health care system better for all people. CMMI Director, Liz Fowler, stated that the PTAC process allows for a unique opportunity to identify strategies and solutions to achieve value-based care in the health system. She hoped to keep PTAC public discussions going as advancing health equity takes off as a national priority, and continue to develop future payment and service delivery models.	Access Other	No
Agency Feedback*	Yes	Access Comment
Agency Feedback Comment*	The establishing statute requires that the Secretary review the comments and recommendations submitted by PTAC and post a detailed response to such comments and recommendations on the Centers for Medicare & Medicaid Services website. Secretarial responses are available at https://innovation.cms.gov/initiatives/pfpms/	Narrative Description*	The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established PTAC, changed the way that Medicare pays physicians and other clinicians and created incentives for them to participate in alternative payment models (APMs). PTAC provides an opportunity for stakeholders to have a role in APM development. PTAC’s comments and recommendations on stakeholder-submitted proposals assist HHS as it considers new models.

COSTS

1. Payments to Non-Federal Members*		1. Est Paymnts to Non-Fed Membrs Nxt FY*
2. Payments to Federal Members*		2. Est. Payments to Fed Members Next FY*
3. Payments to Federal Staff*		3. Estimated Payments to Federal Staff*
4. Payments to Consultants*		4. Est. Payments to Consultants Next FY*
5. Travel Reimb. For Non-Federal Membrs*		5. Est Travel Reimb Non-Fed Membr nxtFY*
6. Travel Reimb. For Federal Members*		6. Est Travel Reimb For Fed Members*
7. Travel Reimb. For Federal Staff*		7. Est. Travel Reimb to Fed Staf Nxt FY*
8. Travel Reimb. For Consultants*		8. Est Travel Reimb to Consltnts Nxt FY*
10. Other Costs		10. Est. Other Costs Next FY*
11. Total Costs	$0.00	11. Est. Total Next FY*	$0.00
Date Cost Last Modified	3/14/2025 9:49 AM	Est. Fed Staff Support Next FY*
Federal Staff Support (FTE)*		Est Cost Remarks
Cost Remarks

Interest Areas

Category Area Health Aging Health Care Hospitals Medical Practitioners Treatment Medicine Diseases Health and Health Research Illnesses

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