certification entities such as the American Board of Medical Specialties and its member boards, might be able to use the data to identify best practices and to assist in making credentialing decisions. Fourth, private accreditation organizations, such as NCQA and JCAHO, and public regulatory programs might use the data in their efforts to assess provider compliance with requirements and to provide information to the public. Fifth, the data will likely be useful to states, communities, and public health groups as a tool for identifying gaps in quality and monitoring the impact of community-wide efforts to close these gaps.

RECOMMENDATION 6: Starting in FY 2008, each government health care program should make comparative quality reports and data available in the public domain. The programs should provide for access to these reports and data in ways that meet the needs of various users, provided that patient privacy is protected.

Many private-sector stakeholders, such as accreditors and purchasers, already impose quality reporting requirements on providers. The committee encourages the government programs to work with these groups on the design, pilot testing, and rollout of the above reports. Doing so will increase the likelihood that these stakeholders will incorporate the standardized measures and reports into their processes, thus further reducing administrative burden.

A mechanism should be established for pooling data from each of the government health care programs. Pooled data would facilitate benchmarking across a wide variety of financing and delivery arrangements, population subgroups, and geographic areas. The availability of such data would also allow for the analysis of more complete care patterns for beneficiaries receiving services under more than one government program.

RECOMMENDATION 7: The government health care programs, working with AHRQ, should establish a mechanism for pooling performance measurement data across programs in a data repository. Contributions of data from private-sector insurance programs should be encouraged provided such data meet certain standards for validity and reliability. Consumers, health care professionals, planners, purchasers, regulators, public health officials, researchers, and others should be afforded access to the repository, provided that patient privacy is protected.

The desirability of providing broad access to the repository by many stakeholders must be balanced by the need to both protect patient privacy and minimize harmful, unintended consequences of public disclosure. Patient-level data included in the repository should be deidentified to pre-



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