An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Measures


Program sponsors said that based on their experience, the use of evidence-based measures that are standardized and have achieved a consensus base (i.e., are NQF  and HQA endorsed) reduces hospital pushback. Sponsors noted that they would like to expand measurement beyond areas in which hospitals are already doing well to avoid the “teaching-to-the-test” phenomenon and to enable a more comprehensive assessment of performance. Areas suggested for additional measurement include: 

Sponsors reported that they were relying on CMS to take the lead nationally in both developing and maintaining measures. Sponsors believe CMS is the most suitable entity to develop reliable and valid measures. They feel CMS’ national presence and leverage will greatly facilitate adoption, leading to more programs using the same measures and thus decreasing the burden placed on hospitals to respond to the growing number of data requests and other new program requirements.

  • Outcomes
  • Resource use/efficiency
  • Transitions in care
  • Medication management
  • Patient experience related to safety
  • Outpatient hospital services.

    The shortage of evidence-based measures in some of these areas will slow efforts to expand measures. 

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