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May 15, 2013

Use of Administrative Data for Public Reporting of Outcomes—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine (Drs Farmer and Bonow) ( and Northwestern University School of Law (Mr Black), Chicago, Illinois.

JAMA. 2013;309(19):1991-1992. doi:10.1001/jama.2013.4547

In Reply: Drs Utter and Romano have made important contributions to society's ability to measure patient safety using patient safety indicators based on administrative (billing) data. But their response to our article is puzzling. Our central claim was that billing data cannot be relied on to simultaneously measure quality, publicly report quality, and pay for performance. If they are, the ability to measure true changes in quality will be lost.

Our secondary claim was that there is currently no substitute for billing data as a widely available basis for measuring outcomes. We concluded that there is an urgent need to develop alternate data sources not currently used for public reporting or reimbursement that will provide time-consistent quality measures.1

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