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Showing posts from 2011

Outcome-Based Performance Measurement Is Becoming the Norm

Hospitals across the country are being pushed and dragged into outcome-based performance measurement systems with increasing incentives for providing quality care and better outcomes. Proponents argue that such systems discourage unnecessary treatments, keep people healthier, and reduce overall costs.


Janet Adams reports in today’s Wall Street Journal ("Wellpoint Shakes Up Hospital Payments," May 16, 2011, B1) that Wellpoint Inc. is raising the stakes for 1,500 hospitals in 14 states serving 34 million people on its Blue Cross Blue Shield plans by cutting off annual payment increases to the hospitals if they fail to deliver quality patient care. Under the new system, Wellpoint will pay increases only to those hospitals that earned them by scoring high enough on outcome measures of treatment quality including how satisfied patients were with the care they received. The change is part of a broader trend in the health care industry toward a compensation approach for health ca…

An Index of the Moment

My colleagues and I at the National Center for State Courts and elsewhere have been thinking long and hard about a “justice index” here in the United States, as well as a similar index, the Global Court Performance Index (GCPI), applicable at an international scale. Though not unschooled in ways and means of performance measurement and management in justice systems, we’ve been daunted by the challenges that the construction of such indexes present.

What should the conceptual framework of the index be – the rule of law, justice systems institutions, legal frameworks, the experiences of citizens with the justice system, and so forth? Should the indicators that comprise the index be drawn from actual performance data available from justices systems, such as case clearance rates and median time in criminal defendants spend in custody before trial, or should the data be drawn from secondary sources, or should new measures be identified and defined? How much weighting should be given to the …

Aggregationists and Non-Aggregationists Unite!

Technology advances will dramatically change the way we do performance measurement and performance management (i.e., the use of performance information in  managements) over the next decade in what I call the "third wave" of court performance measurement. Writing in a special issue of Public Administration Review, the Urban Institute's Harry Hatry predicts that over the next decade managers and their staff will have an enormous amount of performance data at their fingertips.  They will be able to drill through various layers of highly aggregated data to disaggregated data, and slice and dice that data at will. Executives, managers and staff will have access to real-time cross-tabulations of outcomes for numerous variables.  For example, service user satisfaction outcome data might be calculated and displayed for various combinations of variables including identity of user (e.g., litigant, witness, juror), case type that brought users to court, gender, race/ethnicity, ag…