The battle lines are drawn, and the disagreement between healthcare providers and the community of payers and purchasers isas emotional as any to date. On one side, insurance companiesand employers are posting data on quality and costs for hospitals,physician groups, and even individual physicians on their Websites. On the other, health care providers express their outrage,citing the poor quality of the administrative claims data thatare used for most of these "report cards" and the failure ofthe analyses to adjust for socioeconomic status and importantcoexisting conditions. The conflict and the stakes have . . . [Full Text of this Article]
Limitations of Claims Data
Resistance from Providers
Risks and Benefits of Public Reporting
Defining a Middle Ground
Source Information
From Partners Healthcare System (T.H.L.), Massachusetts General Hospital (G.S.M.), Brigham and Women's Hospital (T.A.B.), Harvard Medical School (T.H.L., G.S.M., T.A.B.), and the Harvard School of Public Health (T.A.B.) all in Boston.
Address reprint requests to Dr. Lee at Partners Healthcare System, Prudential Tower, 11th Fl., 800 Boylston St., Boston, MA 02199, or at thlee@partners.org.
Nyweide, D. J., Weeks, W. B., Gottlieb, D. J., Casalino, L. P., Fisher, E. S.
(2009). Relationship of Primary Care Physicians' Patient Caseload With Measurement of Quality and Cost Performance. JAMA
302: 2444-2450
[Abstract][Full Text]
Tu, J. V., Donovan, L. R., Lee, D. S., Wang, J. T., Austin, P. C., Alter, D. A., Ko, D. T.
(2009). Effectiveness of Public Report Cards for Improving the Quality of Cardiac Care: The EFFECT Study: A Randomized Trial. JAMA
302: 2330-2337
[Abstract][Full Text]
Wachter, R. M.
(2009). Entering the Second Decade of the Patient Safety Movement: The Field Matures: Comment on "Disclosure of Hospital Adverse Events and Its Association With Patients' Ratings of the Quality of Care". Arch Intern Med
169: 1894-1896
[Full Text]
Wachter, R. M., Pronovost, P. J.
(2009). Balancing "No Blame" with Accountability in Patient Safety. NEJM
361: 1401-1406
[Full Text]
Johnston, S., Dahrouge, S., Hogg, W.
(2008). Gauging to gain: Primary care performance measurement. cfp
54: 1215-1217
[Full Text]
Johnston, S., Dahrouge, S., Hogg, W.
(2008). Gauger pour gagner: Mesure du rendement en soins primaires. cfp
54: 1220-1222
[Full Text]
Hollenbeak, C. S., Gorton, C. P., Tabak, Y. P., Jones, J. L., Milstein, A., Johannes, R. S.
(2008). Reductions in Mortality Associated With Intensive Public Reporting of Hospital Outcomes. American Journal of Medical Quality
23: 279-286
[Abstract]
Chien, A. T., Chin, M. H., Davis, A. M., Casalino, L. P.
(2007). Pay for Performance, Public Reporting, and Racial Disparities in Health Care: How Are Programs Being Designed?. Med Care Res Rev
64: 283S-304S
[Abstract]
Mandel, K. E., Kotagal, U. R.
(2007). Pay for Performance Alone Cannot Drive Quality. Arch Pediatr Adolesc Med
161: 650-655
[Abstract][Full Text]
Casalino, L. P., Elster, A., Eisenberg, A., Lewis, E., Montgomery, J., Ramos, D.
(2007). Will Pay-For-Performance And Quality Reporting Affect Health Care Disparities?. Health Aff (Millwood)
26: w405-w414
[Abstract][Full Text]
Werner, R. M., Asch, D. A.
(2007). Clinical Concerns About Clinical Performance Measurement. Ann Fam Med
5: 159-163
[Abstract][Full Text]
Pine, M., Jordan, H. S., Elixhauser, A., Fry, D. E., Hoaglin, D. C., Jones, B., Meimban, R., Warner, D., Gonzales, J.
(2007). Enhancement of Claims Data to Improve Risk Adjustment of Hospital Mortality. JAMA
297: 71-76
[Abstract][Full Text]
Normand, S.-L. T., Wolf, R. E., Ayanian, J. Z., McNeil, B. J.
(2007). Assessing the Accuracy of Hospital Clinical Performance Measures. Med Decis Making
27: 9-20
[Abstract]
Persell, S. D., Wright, J. M., Thompson, J. A., Kmetik, K. S., Baker, D. W.
(2006). Assessing the validity of national quality measures for coronary artery disease using an electronic health record.. Arch Intern Med
166: 2272-2277
[Abstract][Full Text]
Peterson, E. D., Roe, M. T., Mulgund, J., DeLong, E. R., Lytle, B. L., Brindis, R. G., Smith, S. C. Jr, Pollack, C. V. Jr, Newby, L. K., Harrington, R. A., Gibler, W. B., Ohman, E. M.
(2006). Association Between Hospital Process Performance and Outcomes Among Patients With Acute Coronary Syndromes. JAMA
295: 1912-1920
[Abstract][Full Text]
Kesselheim, A. S., Ferris, T. G., Studdert, D. M.
(2006). Will physician-level measures of clinical performance be used in medical malpractice litigation?. JAMA
295: 1831-1834
[Full Text]
Birkmeyer, N. J.O., Birkmeyer, J. D.
(2006). Strategies for improving surgical quality--should payers reward excellence or effort?. NEJM
354: 864-870
[Full Text]
Moscucci, M., Eagle, K. A., Share, D., Smith, D., De Franco, A. C., O'Donnell, M., Kline-Rogers, E., Jani, S. M., Brown, D. L.
(2005). Public Reporting and Case Selection for Percutaneous Coronary Interventions: An Analysis From Two Large Multicenter Percutaneous Coronary Intervention Databases. J Am Coll Cardiol
45: 1759-1765
[Abstract][Full Text]
Galvin, R. S., Delbanco, S., Milstein, A., Belden, G.
(2005). Has The Leapfrog Group Had An Impact On The Health Care Market?. Health Aff (Millwood)
24: 228-233
[Abstract][Full Text]
Millenson, M L
(2004). Pay for performance: the best worst choice. Qual Saf Health Care
13: 323-324
[Full Text]
Galvin, R. S., Delbanco, S., de Brantes, F., Volavka, M. P., Gorton, C. P., Lee, T. H., Meyer, G. S., Brennan, T. A.
(2004). A Middle Ground on Public Accountability. NEJM
351: 939-940
[Full Text]
Steinbrook, R.
(2004). The Cost of Admission -- Tiered Copayments for Hospital Use. NEJM
350: 2539-2542
[Full Text]