Opening Up Healthcare’s Black Box

Wouldn’t it be great if you could truly understand the quality and cost of health care?  Wouldn’t it be informative to know how the cost of one procedure in one community compares to the cost of a procedure in another state and how outcomes vary across providers?

The Need for Actionable and Credible Data

Many NRHI members lead multi-stakeholder performance measurement and public reporting programs. Including physicians ensures credible, reliable information, while including patients and purchasers ensures that the information is meaningful to those who need it. Despite great work, progress remains too slow.

We believe that people should have meaningful information about all aspects of their care.

  • Too often, we are missing public reporting
    • Clinical Outcome Measures
    • Patient reported outcomes
    • Patient experience of care
    • Disparities
    • Total Cost of Care for information and resources spent on healthcare in the U.S.
    • What are the barriers to getting this information?

Barriers to Transparency

What are the barriers to transparency?  Listen to physicians from across the country talk about the barriers to transparency and how we need to break down these barriers to improve the health of the communities.




  • Technical barriers
    • Difficulty of compiling data from different sources
      • Difficulty in constructing needed measures that are scientifically correct
    • Business barriers
      • Difficulty obtaining data that is considered proprietary
      • Contractual limits in sharing information
    • Legal Barriers
      • Many privacy rules and regulations may inadvertently inhibit transparency
    • Appropriateness based on guidelines
      • Inadequate evidence defining best practice
    • Human barriers
    • Strong resistance based on the discomfort of having performance measured and reported, and concern about accuracy and fairness

NRHI’s members are committed to making credible, reliable information about healthcare quality and cost transparency available to everyone. In communities across the U.S., RHICs have developed and supported meaningful public reporting initiatives. Key examples include:

  • Maine Health Management Coalition
  • Oregon Health Quality Corporation
  • Massachusetts Health Quality Parthers (MHQP)
  • Minnesota Community Measurement (MNCM)

Nearly all of the public reports on physician quality that exist in the U.S. today have been developed by the Collaboratives. Many of these reports have been used to support value-based payment systems in the communities.

A growing number of NRHI Member Collaboratives are also Qualified Entities, designated to have access to Medicare data to use for measurement and public reporting.

In addition to regional efforts, NRHI members actively participate in national measurement and reporting forums including the national Quality Forum.

So, one of the greatest challenges facing our nation – how do we make the American healthcare system more affordable while maintaining and improving its quality?

It takes a multi-faceted and multi-stakeholder approach.