title: Quality measurement: It's here to stay.
abstract: The Centers for Medicare and Medicaid Services (CMS) is shifting from volume-based to value-based reimbursement of health care services. Measuring the value of health care requires measurement of quality and cost. We provide an overview of quality measurement and review a well-known and widely used conceptual model for assessing quality: structure, process, and outcome. We highlight the advantages and disadvantages of using these types of metrics. We then use this conceptual model to describe prominent CMS programs such as the Physician Quality Reporting System, Physician Compare Web site, and the Medicare Shared Savings Plan. We highlight 2 recent trends: the increasing use of outcome measures to supplement process measures and the public reporting of quality.
authors.affiliation: Department of Neurology (EMC), VA Greater Los Angeles Healthcare System, CA; Department of Neurology (EMC), Geffen School of Medicine, University of California, Los Angeles; Department of Neurology (AES), SUNY Upstate Medical University, Syracuse, NY; Departments of Neurology and Radiology (ABC), Massachusetts General Hospital, Harvard Medical School, Boston; Neurology and Research Services (CTB), VA Maryland Health Care System; and the Department of Neurology (CTB), University of Maryland School of Medicine, Baltimore.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Cheng
authors.affiliation: Department of Neurology (EMC), VA Greater Los Angeles Healthcare System, CA; Department of Neurology (EMC), Geffen School of Medicine, University of California, Los Angeles; Department of Neurology (AES), SUNY Upstate Medical University, Syracuse, NY; Departments of Neurology and Radiology (ABC), Massachusetts General Hospital, Harvard Medical School, Boston; Neurology and Research Services (CTB), VA Maryland Health Care System; and the Department of Neurology (CTB), University of Maryland School of Medicine, Baltimore.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Sanders
authors.affiliation: Department of Neurology (EMC), VA Greater Los Angeles Healthcare System, CA; Department of Neurology (EMC), Geffen School of Medicine, University of California, Los Angeles; Department of Neurology (AES), SUNY Upstate Medical University, Syracuse, NY; Departments of Neurology and Radiology (ABC), Massachusetts General Hospital, Harvard Medical School, Boston; Neurology and Research Services (CTB), VA Maryland Health Care System; and the Department of Neurology (CTB), University of Maryland School of Medicine, Baltimore.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Cohen
authors.affiliation: Department of Neurology (EMC), VA Greater Los Angeles Healthcare System, CA; Department of Neurology (EMC), Geffen School of Medicine, University of California, Los Angeles; Department of Neurology (AES), SUNY Upstate Medical University, Syracuse, NY; Departments of Neurology and Radiology (ABC), Massachusetts General Hospital, Harvard Medical School, Boston; Neurology and Research Services (CTB), VA Maryland Health Care System; and the Department of Neurology (CTB), University of Maryland School of Medicine, Baltimore.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Bever