PPS EXEMPTConsilium
Patent pending
A standing council for cancer technology

Validated at the apex.
Adopted by the field.

Some cancer breakthroughs wait years to reach the people who need them. We find the ones that deserve to move faster — and prove them first at the nation's PPS-exempt cancer centers. What earns its place there reaches the whole field, and the patients counting on it.

For innovators For centers
The Consilium model — an apex of clinical direction and recommendation, over evidence deliberation and a research, guidelines, real-world data, and patient-context foundation; ringed by the multidisciplinary network, access pathways, trusted evidence, and care options.
Our purpose

Strong together, against cancer.

We find the cancer technology that deserves to move faster — and prove it where the evidence counts most, so the whole field can trust it.

The thesis

In oncology, credibility flows downhill.

When the apex centers adopt something, the rest of oncology follows. PPS Exempt Consilium works at that apex — and owns the pathway down from it to every hospital below.

Technology is proven at the eleven PPS-exempt cancer centers, then cascades through the NCCN network, NCI-designated centers, and the community and academic hospitals that treat most patients.

A pyramid showing technology validated at the PPS-exempt apex cascading down through the NCCN (National Comprehensive Cancer Network), NCI (National Cancer Institute), and the community and academic hospitals that make up the broader market.
The collaboration

Brought to the eleven. Advanced together.

We bring promising treatments and emerging technology to the nation's eleven PPS-exempt cancer centers. There, specialists from every discipline and institution weigh it together — and decide what deserves to move forward. One table, many experts, a single shared judgment.

Bring

Treatment options & technology, in

Sourced and curated, then brought to the collaboration for multidisciplinary review.

Collaborate

Eleven centers, one table

The PPS-exempt centers deliberate together — many specialties, many institutions, a single multidisciplinary council.

Advance

What deserves to move forward

Together they identify the advances worth pursuing — and that judgment carries across all of oncology.

Who & why

What is PPS-exempt?

PPS-exempt cancer hospitals are excluded from Medicare's prospective payment system. Instead of fixed per-case rates, they are reimbursed on a reasonable-cost basis — which frees them to adopt and study expensive new technology without the financial penalty other hospitals face. Only eleven hospitals hold this federal designation, and they are among the most research-intensive cancer centers in the country. That combination — the freedom to innovate plus research depth — is exactly what makes them the right apex for validation.

Memorial Sloan Kettering Cancer Center
New York, NY
MD Anderson Cancer Center
Houston, TX
Dana-Farber Cancer Institute
Boston, MA
City of Hope
Duarte, CA
USC Norris Comprehensive Cancer Center
Los Angeles, CA
Sylvester Comprehensive Cancer Center · University of Miami
Miami, FL
Moffitt Cancer Center
Tampa, FL
Roswell Park Comprehensive Cancer Center
Buffalo, NY
The James · Ohio State University
Columbus, OH
Fox Chase Cancer Center
Philadelphia, PA
Fred Hutchinson Cancer Center
Seattle, WA
The designation is fixed by statute — no new centers can be added to the eleven.
The Apex Pathway

One pathway. Three levers.

The framework closes the two gaps that stall new cancer technology — regulatory and reimbursement — by orchestrating the federal expedited pathways through the apex, so the technology that deserves to move faster does. Each lever serves a different tier of the market.

BDD

Breakthrough designation

The FDA lever. Clears and accelerates the regulatory path and qualifies a technology as new — the entry credential that opens every door below it.

Top to bottom
APEX

Apex validation

The PPS-exempt centers are cost-reimbursed, outside the prospective system — so they adopt freely and generate the comparative clinical evidence the field, and CMS, now require.

The apex
NTAP · RAPID

Coverage & payment

The reimbursement pathways that make validated technology adoptable across the prospective-payment market — carrying adoption down to the base of the pyramid.

The broader market
The model

From intake to adoption.

01

Search & identify

We search out the emerging cancer technology that deserves to be expedited and bring it to the Consilium — already filtered, so the centers trust what reaches them.

02

Council review

Each technology is presented to a multidisciplinary council drawn from the apex centers, which assesses merit and designs the evaluation.

03

Apex validation

A coordinated, multi-site study generates the comparative clinical evidence — the asset everything downstream depends on.

04

Cascade distribution

The validated, reimbursable technology rolls down through the NCCN, NCI, and community tiers — with the Consilium holding the path to market.

Proven

Run once by hand. Now a standing pathway.

This model was architected to drive carbon-fiber spine technology into U.S. cancer care — radiolucent implants that don't interfere with radiation therapy or imaging. It worked, informally and without a name.

PPS Exempt Consilium turns that one-time playbook into a repeatable institution — proven once, formalized now, and timed to a reimbursement environment that increasingly rewards apex-grade evidence.

11
PPS-exempt apex centers
3
Federal pathways orchestrated
1
Proven model, now formalized
Carter Lonsberry, Founder of PPS Exempt Consilium Founder
Background

Built on a proven model.

Carter Lonsberry is the architect of PPS Exempt Consilium — and, before it, the architect of carbon-fiber implant adoption for spine tumor care in the United States. That earlier work, beginning with the NCI-designated hospitals, proved the model this venture now formalizes: validate at the apex, then carry what earns it to the field.

Carter Lonsberry
Founder & architect
PDF White paper — “Start at the Apex”
Two doors

Bring a technology, or join the council.

For innovators

Bring a technology

The fastest credible route to apex validation — and a structured channel into the entire oncology market, with the reimbursement pathway built in.

Email to submit a technology →
For centers

Join the council

First access to vetted innovation, multi-site evidence and publications, shared evaluation infrastructure, and a collective-innovation mandate.

Email to request an introduction →
The council

Consilium — a council, by definition.

con·sil·i·um — Latin: a council; deliberation; considered judgment.

The standard is simple and non-negotiable: the evidence must be real. Validation is governed by the centers, never bought — because the moment apex validation reads as pay-to-play, it stops being worth anything.

Partner companies

Technologies in the Consilium.

The companies whose treatment options and technology we bring to the collaboration for validation and advancement.

Decision support

Multidisciplinary.ai

An AI council that deliberates on complex cancer cases across specialties — a deliberation engine that helps multidisciplinary review scale across cases and centers.

Visit multidisciplinary.ai → Open

Your technology here

Bringing a treatment option or technology that deserves to move forward? Introduce it to the Consilium.

Bring a technology →
Go-to-market

The distribution model.

One connection, held at every account — validated at the apex, then carried tier by tier to the field. At each level, PPS Exempt Consilium owns the relationship and the path to adoption.

01 · Apex

Validate & anchor

Direct relationships at the eleven PPS-exempt centers. Generate the evidence and establish the reference accounts.

Account · the eleven
02 · NCCN

Endorse & guide

Carry apex evidence into the guideline-setting network, where adoption decisions ripple outward.

Account · NCCN members
03 · NCI

Expand

Roll into the NCI-designated centers — research-credible, regionally influential adoption.

Account · NCI-designated
04 · Field

Scale

Broad distribution to community and academic hospitals, with NTAP and RAPID reimbursement in place.

Account · the broader market
Begin

Bring a technology to the Consilium.

Proposed concept · no account required · patent pending