The Physician-Focused Payment Model Technical Advisory Committee (PTAC), an independent federal advisory committee, has transmitted a Report to the Secretary of Health and Human Services on key issues related to encouraging rural participation in population-based total cost of care (PB-TCOC) models, which are a type of alternative payment model where payment is made up of costs and utilization for all covered medical services delivered to an individual or group. This report compiles information from previous payment model proposals PTAC reviewed, literature addressing the topic, and input received during a rural-focused meeting last year. They conclude that while value-based care often focuses on improving quality while reducing spending, achieving value in rural areas may require increasing spending. Increasing rural provider participation in PB-TCOC models requires a sustainable glidepath to value-based care that includes a multi-payer approach and a longer glidepath for taking on risk in rural areas. They recommend a multi-pronged approach that would improve rural infrastructure, increase and enhance sustainable funding, enhance recruitment and training of rural health physicians and providers, increase community health organization capacity, and address health disparities.
