Measures That Matter — But To Whom?

The health care and health policy communities are increasingly calling for “measures that matter.” Journal articles and policy reports have highlighted the proliferation of performance measures, and many conferences have focused on reducing the number of metrics to a small set. Overall, there are strong desires to rationalize the entire measurement approach, with leaders like Don Berwick advocating for an immediate reduction in measurement (perhaps by 50 percent).

One notable effort is the CMS-AHIP Core Quality Measures Collaborative, which seeks to align measures across public and private payers. The Collaborative, supported by technical assistance from the National Quality Forum (NQF), has identified core measures for several clinical specialty areas, and further efforts will be needed to identify such measures for additional specialties.

The Institute of Medicine (IOM)’s Vital Signs report took a different approach. The report identified the broad conceptual areas that span across the health care system and community health, and it outlined 15 areas where it is important to assess the nation’s progress, from life expectancy to healthy communities to patient safety to community engagement. The challenge now, as described by the IOM committee leaders, is to identify specific metrics in these areas that can be used for particular and very different situations, such as accountability for public health agencies or assessing a small clinical practice.

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