Two truisms apply to the current state of performance measurement in health care. The first is that if something (eg, a process, an outcome) cannot be measured, it cannot be improved. The second is that it is possible to have too much of a good thing.
The recent enactment of HR 2: Medicare Access and CHIP Reauthorization Act of 2015, the so-called Doc Fix legislation, confirms the broadening societal embrace of the first truism.1 The new law makes plain that public policy makers are intent on measuring the value of health care services and rewarding clinicians and health care entities that improve that value. Private payers are also shifting rapidly to pay-for-performance models, as illustrated by the work of Catalyst for Payment Reform to develop scorecards, databases, and other value-driven tools on behalf of employers and other health care purchasers.