Abstract
ACCURATE MEASURES OF OUTCOMES ARE NECESSARY TO improve the quality of US health care and address geographic, socioeconomic, and racial/ethnic variations in care quality. However, 2 major initiatives that seek to improve quality—public reporting of outcomes and pay for performance (P4P)—have the potential to reduce the reliabilityof theadministrativedataonwhich theyareoften based and generate spurious estimates of performance.
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