How Should California Measure Quality in Health Care?

Among the reforms spelled out in the Affordable Care Act is development of two fundamental activities largely absent in health care -- recognizing and rewarding quality care. The first, and possibly most important, step toward those goals is determining how to measure quality -- both in the delivery of clinical care and in the prevention of illness and injury.

The Obama administration earlier this month announced an initial set of quality measures for state Medicaid agencies to use voluntarily for assessing the care of Medicaid-eligible adults. The HHS measures cover areas such as prevention and health promotion, management of acute and chronic conditions, care coordination, family experiences of care and availability of care.

In California, the Pacific Business Group on Health's Consumer-Purchaser Disclosure Project recently released a report spelling out "Ten Criteria for Meaningful and Usable Measures of Performance." The report urges policymakers to make consumer and purchaser needs and feedback priorities in performance measurement.

The Affordable Care Act gives states the authority to use federal criteria or establish their own set of measures. We asked state officials, stakeholders and experts how California should measure quality in health care...