Paying for performance: Medicare should lead

We the undersigned are united in our belief that a unique opportunity now exists to address the crisis of quality facing the nation’s health system. The human and financial costs of medical error and substandard care have been exhaustively documented. A robust inventory of measures and standards for quality improvement has been developed and continues to grow. The strategic concept of paying for performance—a bedrock principle in most industries—has begun to emerge in health care in a variety of experiments in both the private and public sectors. But further progress is by no means assured. (November 2003)