To the Editor In a Special Communication regarding the association of public reporting of percutaneous coronary intervention (PCI) outcomes with health care quality, Wadhera et al1 conclude that public reporting has not achieved its objectives and suggest potential solutions. We agree with disease-based reporting as a way to elucidate outcomes of variations in care. However, regarding other recommendations, public reporting in Washington is done differently compared with other states mentioned. We participate in a nonmandatory, physician-led reporting program with universal hospital participation and public accountability titled the Clinical Outcomes Assessment Program (COAP).2 The COAP began in 1999 as a statewide intervention to improve the quality of PCI and cardiac surgery. It is an autonomous, collaborative model of confidential clinical data sharing and peer education with a focus on quality improvement that is independent of governmental agencies. We publicly report several process and quality metrics, such as door-to-balloon time in patients with ST-elevation myocardial infarction, PCI appropriateness, radial artery use, postprocedure complications, length of stay, and unplanned coronary artery bypass grafting in addition to in-hospital mortality. These reports are at the hospital level, not the physician level, recognizing that quality and patient outcomes extend beyond the procedure itself.