It’s a giant change to Medicare that could forever change health care in the future in the United States, and it’s based on a bipartisan law passed by Congress last year. The Obama administration has changed how Medicare pays doctors that will be part of a larger shift in health care payments away from paying fees to doctors for tests and procedures, and instead rewarding doctors for taking measures to keep their patients healthy all the time.

The effects are hopefully twofold: it would save Medicare money, and it would improve the level of care patients gets. Congress passed a law in 2015 that would replace a system of cuts to payments to physicians with this, and the Obama administration is taking steps to put it in place.

Doctors have two ways of getting paid through Medicare now. They could get a bonus by meeting quality targets through the Merit-based Incentive Payment System (MIPS), and face a pay cut if they don’t meet those targets. They could also use “advanced” payment models tied to improved quality care as a way of getting paid. Either way, the idea is to shift the burden to doctors to take preventive measures to keep their patients ready rather than simply collecting money for each visit.

The American Medical Association praised the move in a statement.

“The AMA acknowledges the commitment by Acting Administrator Andrew Slavitt and his senior team at CMS for listening to physician concerns and taking several concrete steps to help them adjust to this new Medicare payment framework,” said AMA President Andrew W. Gurman, MD. “By announcing the ‘Pick Your Pace’ approach to give physicians greater flexibility and increased options for participating in MACRA in 2017, HHS Secretary Burwell and Acting Administrator Slavitt took a significant step last month to address AMA concerns about the original proposal. The final rule includes additional steps to help small and rural practices by raising the low volume threshold exemption, and practices of all sizes will benefit from reduced MIPS reporting requirements.”