Performance Measurement in the Hospital Outpatient Setting. Purpose of This Study


In September 2006, the DHHS Assistant Secretary for Planning and Evaluation (ASPE), in collaboration with CMS, issued a contract to the RAND Corporation to conduct a review of performance measures that might be applicable to care provided in the hospital outpatient setting. Specifically, RAND was tasked to conduct an environmental scan to:

  • Determine the leading conditions treated and services/procedures provided in the outpatient setting as a function of volume and costs,
  • Identify existing performance measures that may be applicable to care provided in this setting; and
  • Identify measurement gaps.

The remainder of this report presents the findings of RAND’s environmental scan and is organized as follows:

  • The framework and methods used in this study (Chapter 2);
  • The results of an analysis of 2005 Medicare hospital outpatient data to determine key reasons for visits, as well as key services/procedures and drugs/biologicals provided in this setting, and of a scan of existing measures for those potentially relevant to hospital outpatient care (Chapter 3);
  • A mapping of existing measures to the key reasons for visits, services/procedures, and drugs/biologicals relevant to the Medicare population, and discussion of gaps in existing measures (Chapter 4); and
  • A summary of the key findings, including issues that need to be considered when developing measures for application in the hospital outpatient setting and a series of next steps for advancing CMS’ measures development work in the hospital outpatient setting (Chapter 5).

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