What Is the Principal Purpose of Core Measures?
The workshop participants highlighted several motivations for building a core set of measures. At the most fundamental level, basic measures should reflect and emphasize those issues most important to improving care, lowering costs, and improving health. The measures can then be used to improve program management and to develop incentives and payment systems targeted to the most important issues across the board. How, for example, might core measures be used to track progress in states receiving waivers to increase flexibility in managing Medicaid?
At the practice level, having a common core set of measures should help reduce the burden of measurement imposed by the increasing proliferation of metrics that clinicians and care delivery organizations must collect and report. Several participants noted that the number and scope of metrics has increased steadily over time. These expansive measurement requirements have impacts in cost and human effort, and they also spread attention so broadly that individuals cannot focus on the set of actions that are truly important for improving value and health.
A common set of measures will also allow for the identification of variations, whether among different health care delivery organizations, clinicians, treatments, or population health management techniques. One speaker noted that a common measurement framework in cardiac surgery allowed his organization to identify variations in clinical outcomes among different providers and then share the best practices from high performers throughout the organization. Another speaker emphasized that public reporting of performance measures allows organizations to identify areas that need improvement and to track improvement over time.
Several speakers noted that progress toward the three-part aim often requires diverse coalitions, as multiple factors influence health and health care. With such diverse coalitions, there is a need for integration of information from all partners, including county-based health departments, health care delivery organizations, community-based organizations, and employers. Core measure sets can help these diverse groups work together by defining a common target for improvement and identifying the areas where data need to be collected.
Finally, a common set of core measures can be used to guide the creation of a robust, rational digital infrastructure. One speaker highlighted how his organization in Vermont used core measure sets to identify the