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Health care organizations—from individual family physicians to university health systems and health plans—all shoulder the costs of quality measure reporting. A large health system spent over $5.6 million on quality reporting in 2018, with over $600,000 paid to vendors to report and share quality data, and including more than 100,000 hours of health care staff time.

Quality measurement and reporting requires significant staff effort and expense because of the manual processes involved in the collection, exchange, management and analysis of health care data. A report found that clinicians bear a significant proportion of the cost of quality measurement reporting—an estimated $15.4 billion—including for chart abstraction, data validation and measure reporting. Other industries have leveraged modern information technology to reduce these costs of data management.

Quality measurement is the application of standardized quality measures to evaluate the health outcomes and experiences of care provided to individuals and populations, as well as the structures and processes used by organizations and clinicians to deliver care. The results of quality measurement guide quality improvement and can be used in accountability and value-based purchasing programs.

dQMs pull data from certified health technology, which adheres to patient privacy and protections mandated in the 21st Century Cure Act. Additionally, health information will reside with HIPAA covered entities that safeguard the information and comply with federal and state regulations and standards for handling PHI.

Health plans are implementing “gold carding,” which lessens or removes some administrative work related to prior authorization. Eligibility for gold carding can depend on a provider’s quality ratings, which incentivizes high-quality care. According to an AHIP 2022 survey, 58% of plans use gold carding for medical services—a more than 80% increase from 2019. dQMs can help providers qualify for gold carding with plans.