Abstract
STARTING in 1994 after almost a century of stumbling efforts to measure the quality of health care, the US health care industry appears ready to begin measuring provider performance and to make this information available to the public. In May, the board of commissioners of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Oakbrook Terrace, Ill, approved a number of policies that will radically change the way that organization surveys and accredits hospitals and other health care organizations. Beginning in January 1994, the joint commission will establish an "indicator monitoring system," which will include a national database for comparing a set of "performance measures" that are designed to rate individual health care providers based on patient outcome. In addition, the commission plans to make many of its findings public, ending a confidentiality policy that critics say protects bad providers. "By making the indicator system operational, the joint commission will
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