A Guide to US Quality Measurement
By Allison Viola, MBA, RHIA, and Crystal Kallem, RHIA, CPHQ
WITH THE FEDERAL government ramping up efforts to further tie healthcare reimbursement to quality of care through initia- tives like value-based purchasing and accountable care organi- zations, quality measurement organizations are gaining more national prominence. Many different organizations develop, endorse, implement, and promote performance measures. Trying to decipher and understand the interplay of organizations involved with quality measures can be challenging. The following list serves as a current guide to the country’s quality improvement and measurement efforts.
Healthcare Quality Organizations
Agency for Healthcare Research and Quality
AHRQ develops strategies for quality measurement and im-
x Supporting more than 90 projects in a multiyear effort to
improve patient safety.
x Overseeing the Patient Safety Task Force, a federal ef-
fort to integrate research, data collection, and analysis of
medical errors and promote interagency collaboration in
reducing the number of injuries resulting from these er-
x Facilitating patient safety organizations, which share the
goal of improving the quality and safety of healthcare
delivery. Organizations that are eligible to become PSOs
include public or private entities, profit or not-for-profit
entities, provider entities such as hospital chains, and
other entities that establish special components to serve
By providing both privilege and confidentiality, PSOs create a
secure environment where clinicians and healthcare organizations can collect, aggregate, and analyze data, thereby improving quality by identifying and reducing the risks and hazards associated with patient care.
PSOs provide hospitals, health data organizations, and states
with enhanced quality assessment tools that they can use with
their own hospital administrative data to highlight potential
quality concerns and track changes over time in three areas:
ambulatory care sensitive conditions, inpatient quality (
volume, mortality, and resource use), and patient safety.
Ambulatory Care Quality Alliance
AQA improves healthcare quality and patient safety through
a collaborative process in which key stakeholders agree on a
strategy for measuring performance at the physician or group
level; collecting and aggregating data in the least burdensome
way; and reporting meaningful information to consumers, physicians, and other stakeholders to inform choices and improve
Centers for Medicare and Medicaid Services
CMS conducts a variety of quality initiatives targeting hospitals,
physician offices, nursing homes, home health agencies, and
end-stage renal disease facilities. Physicians and other eligible
professionals can participate in the Physician Quality Reporting
Initiative (PQRI), the Hospital Inpatient Quality Reporting program, and the EHR meaningful use incentive program.