CMS and AHIP's quest to tame the wilds of healthcare quality measures

The Obama administration and health insurers took a step Tuesday toward standardizing and improving the measures that are intended to gauge the quality of healthcare but are widely criticized as too burdensome for providers and too numerous or irrelevant to be much help to consumers.

The CMS and the trade group America's Health Insurance Plans announced an agreement to adopt a core set of quality measures for the nation's doctors. Officials say the measures are necessary as payers and consumers bear more responsibility for finding and purchasing high-quality care and providers are increasingly paid under contracts tied to their quality performance.

The agreement—which outlines seven sets of quality measures to be used across public and private payers—is the first to be announced by the Core Quality Measures Collaborative, which includes the CMS, AHIP, the American Academy of Family Physicians and the National Partnership for Women and Families. The National Quality Forum, an endorsement body for industry quality standards, was a technical adviser.

The announcement comes as industry stakeholders and policymakers struggle with how to best identify and reward high-quality healthcare. Quality metrics are increasingly tied to how much doctors and hospitals are paid. By 2018, HHS said last year, half of Medicare spending outside of managed care would be allocated under contracts with rewards and potential penalties for quality outcomes.

Experts have criticized existing quality measures as ineffective or poorly developed. Healthcare executives, meanwhile, have argued for greater standardization to avoid added costs and confusion as the federal government and various insurers develop different metrics.

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