An ongoing initiative by the Obama administration to link Medicare reimbursements to performance got a big endorsement from major insurers Tuesday.
Officials from the Centers for Medicare and Medicaid Services (CMS) and America's Health Insurance Plans, the powerful insurance lobby, announced that they have agreed on seven measures to assess doctors.
While policymakers have been bemoaning the fee-for-service model that they say drives up costs for both public and private health care programs, moving the entire health care system towards an outcome-based model is daunting because of a health care market that is fragmented by state and insurance networks.
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While insurers have in the past set up their own outcome-based measures with providers, the announcement signals an attempt to develop universally recognizable standards that doctors will be able to expect from all payers, private and public.
"In the U.S. health care system, where we are moving to measure and pay for quality, patients and care providers deserve a uniform approach to measure quality," said CMS Acting Administrator Andy Slavitt in a statement. "This agreement today will reduce unnecessary burden for physicians and accelerate the country's movement to better quality."
Said Carmella Bocchino, executive vice president of AHIP, in a statement: "This process will ensure measures and reporting are consistent across programs in both the private and public sectors."
The plan has also earned plaudits from doctors, who hope that uniform quality measures will make their dealings with insurers and public health programs less complicated and more predictable. The American Medical Association lauded the deal in a Tuesday statement.
"The AMA looks forward to continuing to participate in this initiative dedicated to alignment of quality measures because it has the potential to improve the health of the nation while also reducing administrative hassle that can lead to improved professional satisfaction and sustainability of physician practices," said AMA President Steven J. Stack.
The new sets of quality measures will cover seven major medical areas: Primary care, cardiology, gastroenterology, obstetrics and gynecology, orthopedics, HIV and hepatitis C, and orthopedics.
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