This report provides an overview of performance measurement in U.S. health care, and includes policy recommendations aimed at improving the performance measurement enterprise.
Specifically, they recommend how to develop better measures; when and how to use measures; and how to ensure the validity and comparability of publicly-reported performance measure data.
1. Decisively move from measuring processes to outcomes.
2. Use quality measures strategically, adopting other quality improvement approaches where measures fall short.
3. Measure quality at the level of the organization, not the clinician.
4. Measure patient experience with care and patient-reported outcomes as ends in themselves.
5. Use measurement to promote the concept of the rapid-learning health care system.
6. Invest in the "basic science" of measurement development.
7. Task a single entity with defining standards for measuring and reporting quality and cost data, similar to the role the Securities and Exchange Commission (SEC) serves for the reporting of corporate financial data, to improve the validity, comparability, and transparency of publicly-reported health care quality data.
The authors conclude that the interest in promoting a health care system that rewards performance needs to be balanced with the practical challenges faced when measuring performance. Improvement requires substantial investments in the underlying science of performance measurement, greater care in communicating measurement results, greater attention to the role of measures in quality improvement efforts, and using performance data in more strategic ways. The adoption of flawed measurement approaches that do not accurately discriminate between providers can undermine professional and public support for provider accountability, reward indiscriminately, and divert attention from more appropriate and productive quality improvement efforts.
Urban Institute Real Time Policy Analysis
These reports, also called "quick strikes," are a series of timely briefings examining a wide variety health insurance coverage issues in the United States.Learn more about the series
- About this grant
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
RWJF examines the types of competitive foods - foods and beverages schools offer outside of meal programs - available in our nation's school...
Recent studies have demonstrated a connection between low-socioeconomic status and poor health in children. This study builds upon previous ...
This study examined the impact that race has on the prevalence of self-reported diabetes for Hispanic and non-Hispanic people. Data from the...
In this article, the authors consider the social, structural and symbolic effects of the recent and rapid spread of legal gambling in the Un...
Immigrants and their children are one of the fastest growing components of the U.S. population. One in five Americans under the age of 18 is...
Most studies investigating links between social capital and health have relied on work by Robert Putnam who conceptualized social capital as...
The present article considered cardiovascular patients' adherence to physicians' medication recommendations. Nonadherence was defined as fol...
This study examined the prevalence of attention-deficit/hyperactivity disorder (ADHD) among children in the United States. Also of interest ...
The current article explored risk factors for iron deficiency for toddlers in the United States with a focus on Hispanic toddlers. Data from...
The research presented in this article compared the density and concentration of pro-tobacco media messages in African-American and White ma...
This article describes efforts to use information on influenza burden and vaccine efficacy to estimate how influenza vaccine recommendations...