Physician-focused Payment Models Recommended to Secretary Price
Group recommends that Secretary Price approve two proposals: Project Sonar and the Episode Grouper for Medicare. Learn more here!
In April, the Physician-Focused Payment Models Technical Advisory Committee (PTAC) had its first meeting to review and vote on proposals it has received. Following an in-depth review and discussion with the physician leaders who had submitted the proposals, the PTAC voted to recommend two proposals to Health and Human Services Secretary Tom Price, MD, for limited testing.
The first, called Project Sonar, has been spearheaded by Lawrence Kosinski, MD, an Illinois gastroenterologist. With support from a private payer, it has demonstrated significant improvements in care for patients with inflammatory bowel disease (IBD). Project Sonar engages these patients in an interactive process that allows the gastroenterology team to take steps to reduce exacerbations that would otherwise lead to emergency visits and hospital admissions.
The second model recommended by PTAC for testing is the Episode Grouper for Medicare (EGM) developed by the American College of Surgeons and Brandeis University. The EGM model will provide data to teams of physicians managing episodes of care that can help them to improve quality and outcomes of care and lower avoidable spending.
Both models hold promise for improving patient care as well as providing a means for specialist physicians who have had few opportunities to participate in alternative payment models to effectively do so. In remarks at the PTAC meeting, Secretary Price strongly encouraged the physician community to submit additional proposals for new models to the PTAC. He emphasized the need to avoid a one-size-fits-all approach and noted that we are in a time of great innovation in clinical medicine that requires innovation in payment models as well.
Learn more about both of these models at AMA Wire, and listen to a podcast interview with Dr. Kosinski about Project Sonar. The AMA website offers additional details on APMs and how to develop APMs.