Quality, Transparency, and the US Government

Some solutions for producing a better health care system in the United States and abroad call for paying clinicians more for better performance. For this solution to work, valid and reliable measures of performance must be available. Although the quality-of-care field has matured and many such measures have been produced, a need for better methods and indicators by which performance can be assessed remains. In 2001, the government of California, responding to calls to improve quality of care, decided to produce routinely available statewide reports on mortality following isolated coronary artery bypass surgery, by hospital and physician. The outcome-reporting program is housed in the Office of Statewide Health Planning and Development. The author was asked to chair the committee that oversees the production of these reports, the purpose of which is to increase public and professional knowledge about this procedure.