The primary activities of the Agency for Health Care Policy and Research (AHCPR) relevant to performance monitoring include the development of clinical practice guidelines, technology assessment, support for outcomes research, and applied research on health care quality measurement and improvement.
One relevant project is collecting and classifying clinical performance measures being used by health care providers in the public and private sectors (Center for Health Policy Studies and Center for Quality of Care Research and Education, 1995). This "typology project" is producing a database with information on about 1,300 individual measures found in 40 measurement systems. The database will allow users to explore specific measures within the project's classification system and to identify measures linked to specific clinical conditions or patient populations. Anther project was aimed at producing information that can help consumers choose among health plans (Research Triangle Institute, 1995). It focused on developing questionnaires that could be used to collect information from and for health care consumers. Specific areas of attention include access to care, use of services, health outcomes, and satisfaction with care. The Consumer Assessment of Health Plans Study is following up the initial work.
Public health agencies have generally been responsible for broad community health needs but in many communities have also been providing personal health services. In the private sector, the growth of managed care organizations (MCOs) is shifting attention from individual patients to entire enrolled populations, including groups formerly served by public health agencies. The Centers for Disease Control and Prevention (CDC), guided by a Managed Care Working Group, is examining its role in this changing health care environment.
CDC is encouraging MCOs and other private sector health care providers, in collaboration with public health agencies, to