An Evaluation of the Use of Performance Measures in Health Care

An Evaluation of the Use of Performance Measures in Health Care

Cheryl L. Damberg
Melony E. Sorbero
Susan L. Lovejoy
Katharine Lauderdale
Samuel Wertheimer
Amber Smith
Daniel Waxman
Christopher Schnyer
Copyright Date: 2011
Published by: RAND Corporation
Pages: 68
https://www.jstor.org/stable/10.7249/j.ctt3fh27c
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  • Book Info
    An Evaluation of the Use of Performance Measures in Health Care
    Book Description:

    This report presents the results of an evaluation of health care performance measures, describes how performance measures are being used by a wide array of organizations and the types of measures being used for different purposes, summarizes key barriers and facilitators to the use of measures, and identifies opportunities for easing the use of performance measures moving forward.

    eISBN: 978-0-8330-7938-1
    Subjects: Health Sciences, Business

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-vi)
  4. Figures
    (pp. vii-viii)
  5. Tables
    (pp. ix-x)
  6. Summary
    (pp. xi-xviii)

    Over the past two decades, a wide array of standardized health-care performance measures have been developed, and a large number of these have been endorsed by the National Quality Forum (NQF). During this period, there was also substantial growth in the number of entities using health-care performance measures for a host of purposes. Quality and efficiency measures are now embedded throughout the U.S. health-care system, as demonstrated by their widespread use for accountability; accreditation, certification, credentialing, and licensure; public reporting; pay for reporting (P4R); pay for performance (P4P) and performance-based contracting; tiering and construction of narrow provider networks; quality improvement...

  7. Acknowledgments
    (pp. xix-xx)
  8. Abbreviations
    (pp. xxi-xxii)
  9. CHAPTER ONE Introduction
    (pp. 1-4)

    Over the past two decades, there has been substantial growth in the number of entities using health-care performance measures for a host of purposes. Quality and efficiency measures are now embedded throughout the U.S. health-care system, as demonstrated by their widespread use for accountability; accreditation, certification, credentialing, and licensure; public reporting; pay for reporting (P4R); pay for performance (P4P) and performance-based contracting; tiering and construction of narrow provider networks; quality improvement (QI); and public recognition. Performance measures are being used by the following:

    providers and integrated health systems for QI and for use internally in incentive-based performance schemes with their...

  10. CHAPTER TWO Study Methods
    (pp. 5-12)

    In this study, we focused on understanding measure use related to four broad purposes or end uses:

    accreditation, certification, credentialing, and licensure

    public reporting

    QI

    payment and network selection.

    If organizations stated they were using measures in other ways, we also captured the other uses mentioned. Although there was strong interest in learning about the use of NQF-endorsed measures, RAND also explored the use of nonendorsed measures for the different end uses and the rationale for using nonendorsed measures.

    The study addressed the following four overarching questions, with subtopics listed below each question:

    How are performance measures being used in...

  11. CHAPTER THREE Study Findings
    (pp. 13-28)

    In summarizing the findings that address the first research question, “How are measures of performance being used in practice?” we draw information gleaned from both the key-informant interviews and the document review. For research questions 2–4, our findings are based on what we learned from the key-informant interviews because the document review did not generate information to address these questions.

    In conducting our review of publicly available documentation on the use of performance measures, we cataloged uses by 11 different types of end-user organization categories. We identified 127 discrete uses among 70 organizations, with more than half reporting multiple...

  12. CHAPTER FOUR Conclusions
    (pp. 29-30)

    As the measurement development, endorsement, and application communities reflect on the results of this study, we note that several issues emerged that represent opportunities and potential areas of focus moving forward to help facilitate the use of measures:

    Establish priorities for where end users should focus their attention and resources. Although NQF has a large number of endorsed measures, the sheer number is daunting to end users, and many measures are viewed as irrelevant or low impact. Given the limited resources and attention that end users can devote to measurement, they need guidance on defining a more limited set of...

  13. APPENDIX A Members of the Evaluation of Measure Use Expert Advisory Panel
    (pp. 31-32)
  14. APPENDIX B List of Organizations Included in the Document and Website Review
    (pp. 33-34)
  15. APPENDIX C Breakdown of Measure Uses in Sample of Organizations Undergoing Document and Website Review
    (pp. 35-36)
  16. APPENDIX D Additional Data Summary Tables from Document and Website Review and Key-Informant Interviews
    (pp. 37-44)
  17. References
    (pp. 45-46)