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October 2007
Ensuring High Quality, Affordable Health Care

There is wide variation in the quality of health care available to Americans, and that the variation in care has significant costs in lives and dollars. One of the ways to bridge the gap between the care that people receive and what the health system is capable of delivering is through performance measurement and reporting initiatives – ones that are meaningful for consumers and purchasers, as well as for those being measured. Transparent, public information not only encourages consumers to consider quality and cost-effectiveness in their health care decisions, but also guides effort to improve outcomes and slow the rise of health care costs. In the absence of quality measurement and information, patients suffer the most.

Below are "fact sheets" that summarize critical elements for improving quality and affordability as well as potential solutions to make our health care system work well for those it serves. We hope that you will download them to learn more about these issues, and use them when you talk to policy makers, opinion leaders, and other stakeholders about the need for reforming the health care system. You can download PDF versions of the fact sheets, as well as Word versions you can alter and personalize for your own use.

  • Overview of the fact sheets (PDF) (Microsoft Word)
  • Measuring and reporting on the quality and costs of care to create a transparent health care system (PDF) (Microsoft Word)
  • Providing tools that help consumers make good health care decisions (PDF) (Microsoft Word)
  • Rewarding providers who deliver better care (PDF) (Microsoft Word)
  • Encouraging the rapid adoption of health information technology (PDF) (Microsoft Word)
  • Creating a health care system that delivers the right care at the right time in the right setting (PDF) (Microsoft Word)
  • Ensuring our health care system provides high quality care for everyone (PDF) (Microsoft Word)

Download All Fact Sheets (PDF) (Microsoft Word)


October 2007
Using Electronic Data for Performance Measurement

The urgency consumers and purchasers feel for information to make well-informed decisions about health care is frequently out-of-synch with the slow pace of performance measure development and reporting. Electronic data, and in particular electronic health records, hold the promise of being the means to a feasible data system more readily able to collect robust measures of performance. This issue brief describes electronic data, compares it to other sources of data used for performance measurement, and highlights actions to speed its use.
Full Document


September 2007
A Pocket Guide to Seven Key Measurement Issues

In discussions with clinicians and researchers, consumer advocates and purchasers often encounter common arguments. This guide provides talking points which articulate purchaser and consumer positions on seven key issues and draw on the Institute of Medicine's definition of health care performance – a multidimensional concept which includes safety, timeliness, effectiveness, efficiency, equity and patient-centeredness.
Full Document


Measures to Market Project

November 2006
Measures to Market Report
The Disclosure Project commissioned a broad-based research effort with support from the Robert Wood Johnson Foundation to identify business models that would support and sustain all elements of the measurement enterprise, spanning measure development, endorsement, data collection and reporting of physician performance in the ambulatory setting. Despite pioneering efforts by numerous regional and national organizations, sustainable business models that support all of the required business activities remain elusive. The Measures to Market report identifies two business models for their potential to accelerate broad-based, sustainable performance measurement and reporting. The two models both share a "Common Foundation" for the business activities of measure development, maintenance, consensus and endorsement and both reflect public/private engagement.
Executive Summary
Full Report
View presentation


September 30, 2006
Guidelines on Physician and Hospital Performance Updated
An uncommon coalition of more than 25 of the nation's leading consumer, employer and labor organizations have announced guidelines to promote rapid, industry-wide adoption of performance measures to help patients compare the relative quality and cost of care provided by the nation's hospitals, physicians and health care systems. These guidelines have been updated to recognize other quality alliances, such as AQA or Hospital Quality Alliance, that engage in consensus measure selection.
Press release
Download guidelines
Endorsing organizations


June 30, 2005
Principles for Making Medicare Payments Performance-Sensitive
A broad cross-section of consumer and employer organizations – representing more than 100 million Americans – have called for Medicare to publicly report and pay physicians, hospitals, health plans, and other providers on how well they deliver high-quality, efficient, and patient-centered care.
Press release, principles, and endorsing organizations


May 2004
State Experience in Health Quality Data Collection
Today, statewide health care data collection efforts exist in 48 states and the District of Columbia. The structure, function, and governance of these organizations varies markedly from one to another. Spurred by the work of the Institute of Medicine, national attention to the issue of medical care quality and the need for data to measure it has greatly increased. This paper documents the richness of the diversity of the state experience and includes some observations on the elements that have proved critical, at the state level, to ensure the data system enjoys continued support.
Full Document


July 2003
More Efficient Physicians: A Path to Significant Savings in Health Care

The Disclosure Project advocates for making information across all of the Institute of Medicine's six domains of health care quality – safe, timely, effective, efficient, equitable, and patient-centered – available and actionable. One of those domains that has received strikingly little attention, given the cost pressures being felt by purchasers and consumers, is the relative efficiency with which care is delivered. To help inform the discussion about Medicare reform and private sector efforts to reward more efficient physicians, the Disclosure Project sought out the opinions of leading actuaries and health researchers to estimate the potential savings to Medicare if either a small portion of beneficiaries began using more efficient physicians or a similarly small proportion of physicians improved the efficiency of their practice pattern. The conclusion: Medicare and other purchasers could save from 2% to 4% of total costs if only one out of ten beneficiaries were to move from less efficient to more efficient physicians.
Brief Summary
Full Document

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