American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

ACS Medicare Advanced Alternative Payment Model Clears Key Hurdle

The Physician-Focused Payment Model Technical Advisory Committee (PTAC), on April 11, recommended that the Secretary of the U.S. Department of Health and Human Services (HHS) approve the American College of Surgeons (ACS)-Brandeis Advanced Alternative Payment Model (A-APM) for limited-scale testing.

The ACS-Brandeis A-APM is an episode-based payment model that uses software to process and group claims data using physician-reviewed clinical specifications, including trigger codes and relevant services. The model measures quality across the phases of surgical care and couples high-value process measures with patient-reported outcomes. Participants can be rewarded for reducing unwarranted variation and providing efficient, high quality care. The ACS began developing the model by working with a team at Brandeis University, Waltham, MA, soon after passage of the Medicare Access and CHIP (Children’s Health Insurance Plan) Reauthorization Act (MACRA) of 2015, with the goal of providing more surgeons with the opportunity to participate in the law’s A-APM track.

The PTAC was created under MACRA to spur development of new APMs for Medicare-participating physicians. The ACS-Brandeis A-APM was the first submission that the PTAC received last December and was one of two proposals approved at the April meeting. The PTAC will next send a formal report with its recommendation to the HHS Secretary, who will review the recommendation and decide whether the proposal should be sent to the Centers for Medicare & Medicaid Services for implementation.  

For more information, contact Matt Coffron, ACS Manager of Policy Development, at mcoffron@facs.org.

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