Summary: Only a fraction of the wide variety of services individual physicians and physician groups typically perform can be clearly linked to measurable outcomes that reflect quality of care. Current approaches to performance measurement generally focus on physician groups rather than individual physicians and measure not outcomes but processes, such as whether the services that are provided accord with agreed-upon norms. Several private and public organizations in California, New York, and Pennsylvania have developed report cards that provide information closer to the level of the individual physician than health plan report cards do, although they do not always help consumers make informed choices about physicians. The accuracy and completeness of the report card data and the adequacy of the risk adjustment methodologies also limit consumers' and physicians' confidence in them. Several national accreditation organizations as well as the Department of Health and Human Services are working on developing common performance measures and on establishing standards for administrative claims and encounter data.
