PTAC members stress conveners, simplification and predictable funding as keys to multi‑payer alignment

Members of PTAC on Friday told officials overseeing the committee that forging multi‑payer alignment and scaling value‑based care will require strong conveners, simpler program designs and predictable, multiyear funding.

Krishna Ramachandran, a PTAC member who opened the session, said the committee will issue a report to the secretary of the Department of Health and Human Services summarizing the meeting’s findings and invited members to surface topics for deliberation.

"What we're really trying to do is move, communities integrated systems from a transactional relationship to a partnership model," said Lauren, summarizing a common thread from expert presentations and arguing that conveners and upfront investment are essential to sustain system‑level redesign. She added that shared infrastructure such as a single health information exchange and common analytics can equalize access, particularly for rural communities.

Several members echoed that investment and leadership from large payers and federal agencies are critical. Lee said the needed change is "culture change in a community" and argued that including Medicare Advantage in alignment efforts is important to reach a sufficient share of patients for providers to engage. "Only when it's included do you get to the 60 or 70% of a patient population that's required to get engagement," Lee said.

Speakers repeatedly called for simplification of programs and measures. Larry said simplification was heard throughout the day and urged a "push from above," noting that imposing common approaches without CMS at the table makes coordination difficult. "Whenever you need an actuary to calculate something, you have a barrier," he said, urging simpler, more predictable payment structures and citing a Pennsylvania experiment that used prospective budgeting to give hospitals predictable revenue streams.

Members discussed specific technical barriers: one committee member praised an expert’s five‑component framework and emphasized attribution differences across payers, while Josh noted the tradeoffs between standardization and local flexibility and warned that risk‑adjusted models will still require actuarial and statistical work. "We just, like, need to acknowledge that there's a trade off there," Josh said.

Walter summarized the practical policy checklist emerging from the day: CMS or regional conveners, timely data, clear attribution, a concise core quality‑measure set and equitable payer cost‑sharing to avoid forcing providers to cross‑subsidize transformation. He flagged several unanswered operational questions, including how to engage Medicare Advantage at scale given plan heterogeneity and what legal waivers or market flexibilities might enable durable financing.

Lindsay stressed time horizons and data infrastructure, urging long‑term stability—"not for next year, but for 20, 30 years"—and described HIE‑enabled data sharing as a public‑good enabler of coordination and reduced low‑value care.

The committee did not take formal votes during the meeting. Ramachandran closed by thanking participants and staff, reminding members the next session will convene tomorrow at 9:00 a.m. ET with public comment scheduled at approximately 10:50 a.m., and adjourning for the day.

The meeting’s next procedural step is the continuation of expert panels and committee discussion at the next session, followed by PTAC’s report to the HHS secretary.