TABLE 2-4 Examples of Organizations That Measure Performance



AQA Alliance

In 2004, the American Academy of Family Physicians, the American College of Physicians, and America’s Health Insurance Plans joined with AHRQ to create the AQA Alliance (originally the Ambulatory Care Quality Alliance). The AQA Alliance has developed a collaborative process in which physicians, consumers, purchasers, health insurance plans, and others develop strategies for measuring performance at the physician or group level; collecting data; and reporting the information to consumers, physicians, and other stakeholders.

The Joint Commission (formerly JCAHO)

A nonprofit organization established in 1951, the Joint Commission evaluates 15,000 health organizations in the United States and provides accreditation to those meeting its quality standards. The Joint Commission sets standards to ensure the quality and the safety of the care provided. Performance measures supplement the standards-based survey process by providing specific performance targets, allowing ongoing performance monitoring, and working toward continuous improvement.


A nonprofit organization founded in 1990, the NCQA accredits health organizations to provide consumers and employers with an indicator of quality. The NCQA develops quality standards and performance measures, building consensus among large employers, policy makers, physicians, patients, and health plans to decide what aspects of quality to measure, how to measure it, and how to promote improvement. The NCQA tracks quality through the Health Plan Employer Data and Information Set and publishes annual reports on its findings.


A nonprofit membership organization founded in 1999, the NQF was established as a public-private partnership to promote a common approach to measuring and reporting health care quality. The NQF includes participation from consumers, public and private purchasers, employers, professionals, provider organizations, health plans, accrediting bodies, and others. Its goals are to promote collaborative efforts, develop a national quality measurement and reporting strategy, standardize health care performance measures, promote consumer understanding of quality information, and promote an enhanced system capacity for evaluation.

NOTE: JCAHO = Joint Commission on Accreditation of Healthcare Organizations; NCQA = National Committee for Quality Assurance; NQF = National Quality Forum.

SOURCES: AQA Alliance (2006); The Joint Commission (2007); NCQA (2007); NQF (2007).

know how a particular intervention is likely to affect patients with multiple comorbidities, such patients are frequently excluded from research studies and are often not covered by clinical guidelines (Boyd et al., 2005). In addition, relatively little is known about interventions for rare diseases

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