Reimagining Quality Measurement

In a reimagined approach, quality measurement in health care would be integrated with care delivery, address the challenges that confront doctors every day, and reflect individual patients' preferences and goals for treatment and health outcomes. The quality-measurement enterprise in U.S. health care is troubled. Physicians, hospitals, and health plans view measurement as burdensome, expensive, inaccurate, and indifferent to the complexity of care delivery. Patients and their caregivers believe that performance reporting misses what matters most to them and fails to deliver the information they need to make good decisions. In an attempt to overcome these troubles, measure developers are creating ever more measures, and payers are requiring their use in more settings and tying larger financial rewards or penalties to performance. We believe that doing more of the same is misguided: the time has come . . .