The federal government and private insurers are working together to standardize the way doctors are evaluated and paid, in hopes of improving care for millions of Americans and cutting down on rampant waste in the U.S. healthcare system.
The new initiative is a major step in simplifying and clarifying how medical providers are paid, said officials with the Centers for Medicare and Medicaid Services and America's Health Insurance Plans, the major national association for private insurers.
"I think for patients it is a clear signal around public and private payers and providers on agreeing on what are the measures we have that are most important, and it focuses the system on those measures," said CMS Chief Medical Officer Patrick Conway.
The new set of measurements will apply in seven main areas of care, including cardiology, gastroenterology, HIV and Hepatitis C, oncology, obstetrics and gynecology, orthopedics and primary care.
While CMS will propose the new measurements throughout the year, as part of the agency's normal rule-making process, private insurance plans will adopt the changes on more of a rolling basis, as their contracts with medical providers come up for renewal.
Health officials expressed hope on Tuesday that the new measurements will advance their long-held goal of improving the quality of healthcare around the U.S., which has among the highest rates of obesity and chronic conditions and spends more per capita of any developed country.
In the current system, doctors deal with an average of seven public and private payers, all of which have different ways of determining how much they get paid for different services.
Payers often impose between 50 and 100 measurements doctors have to pay attention to, which can leave them with lots of unnecessary paperwork and confusion about how to submit claims for care, said Doug Henley, chief executive of the American Academy of Family Physicians.
Under the new system, which is estimated to affect about 70 percent of insured Americans, there will be fewer quality measurements and they will be clearer, officials said.
"The set for primary care we're releasing today is 21 measures which, if harmonized across payers, would simply the life of every family physician," Henley said. "This represents a huge step forward in terms of providing better-quality care to patients."