The YOU FIRST Approach to Quality Measurement

April 18, 2024 · Andy Reynolds

  • A new kind of quality measure is gaining traction: Person-Centered Outcome (PCO) measures that focus on measuring what matters to patients.
  • Mounting evidence shows PCO measures are feasible and that providers and patients like them.
  • A recent NCQA webinar discussed encouraging findings from our latest round of PCO testing, prompting us to begin recruiting Special Needs Plans to test PCO measures.

The Value of PCO Measures

PCO measures are personalized, structured, measurable goals for adults who require complex care because of one or more chronic conditions due to medical, behavioral health or social needs.

Most quality measures focus on specific diseases or health conditions. PCO measures are different and more flexible, and they relate to what patients care about—often they are practical, specific aspirations like “Walking my daughter down the aisle at her wedding in 3 months.”

Standardizing PCO measures comes from translating patient preferences into a SMART sequence of three measures:

  • Measure 1 – Goal Identification. The patient and provider agree on:
  • Measure 2 – Goal Follow-up. Providers follow up on the goal, 2 weeks to 6 months after the patient and provider agreed on it.
  • Measure 3 – Goal Achievement. The “outcome” part of PCO: Was the goal met?

PCO measures have long been in geriatric care. Now, they’re proving useful in more populations and places.

Generous support from The John A. Hartford Foundation, The SCAN Foundation and Gordon and Betty Moore Foundation has allowed NCQA to study PCO measures:

  • In 30 practices across 17 states.
  • Among more than 180 clinicians and 5,000 clients or patients.
  • In varied settings, including Certified Community Behavioral Health Clinics (CCBHC), behavioral health homes, home-based primary care practices, home and community-based services programs and serious illness programs.

Testing shows PCO measures work!

Our March webinar on PCO measures featured clinic managers who helped us test PCO measures in a multi-state learning collaborative.

Feedback was positive:

  • “It was a good way to engage and hit an on-ramp to get to what members wanted to work on.”
  • “This approach made it easier to focus and think about what patients wanted.”
  • “These measures are great. It sets a visual on progress made.”

Our research also shows that the PCO approach helps patients feel heard and more involved in their care.

PCO Measurement Supports Other Goals


Everyone deserves the chance to be as healthy as possible, no matter who they are or where they come from.

PCO measures advance health equity by:

  • Translating people’s priorities into care plans.
  • Making goal achievement part of quality assessment.
  • Giving providers a common language for tracking services patients care about.

The CMS National Quality Strategy emphasizes health equity and person-centered care, creating a mutually reinforcing relationship.


Behavioral health is a NCQA priority, so it’s no surprise that our March webinar celebrated the successful test of PCO measures in CCBHCs:

  • PCO measures are for people with complex care needs.
  • Behavioral healthcare is complex.
  • Standardizing outcome measures is hard.

PCO measures’ flexibility means they’re a good match for assessing behavioral healthcare.

See our free PCO toolkit and courses, which include modules about behavioral health. (Details below.)

What’s Next

We’re expanding usage of PCO measures into other areas:

  • Long-Term Services and Supports. Starting next year, our LTSS programs will include PCO elements.
  • HEDIS. Expect to see PCO measures in our main measure set by 2027.

How You Can Use PCO


  • Join our learning collaborative. We’re looking for 3–5 SNPs to join a learning collaborative that will implement and test PCO measures.

    SNPs, this is your chance get a head start and help us plot a better path to measuring quality!Email us if you’re interested.



  • Contact our PCO team. We can answer your questions, and we want to hear your ideas about this promising way to measure quality.
Section background
Section graphic
Section element
Section element
Stay Informed

Get updates, announcements and trending topics

Join 35k+ health care professionals