Performance Measurement Evolution For Accountable Communities of Care

Health care performance measurement has been largely focused at the provider and micro-system level with an emphasis on process measures performed by and attributable to individual clinicians that can be aggregated into groups, hospitals, and health plans. Transformation of US healthcare depends on a different set of measures that encourage integration and coordination across providers, settings, and time; improves communications through HIT; and maintains a persistent emphasis on patient centered care. As payment approaches change from fee for service to global payments, the delivery system will change toward accountable care organizations. This progression of accountability to higher levels of systemness has a logical extension to community approaches that integrate community resources and hold communities accountable for the well being of its residents. Measurement of quality takes on a new dimension when communities are the unit of measurement and integration is required across a variety of domains including health, healthcare, environmental, educational and other determinants of overall community health. This session will address the performance measurement requirements of this progression of systemness to its highest level at the community level. We will review public health surveillance measures and health care system measures; composite measures on healthy lifestyles and provision of the most effective preventive services; and indices of community health. We will draw on thought leaders in community health measurement from the National Priorities Partnership, the Commonwealth of Massachusetts, and from communities engaged in this work. Ultimately, it is all about the health of residents in communities and how all stakeholders contribute to this vital community need.