Moving toward a more patient-centered health care delivery system.

Quality-of-care measurement has not kept pace with the recent shift toward policy approaches that rely on patients to contain costs and improve quality. If patients are to play a critical role in care, then the degree to which providers support and improve patients' capabilities for participation must also be part of the quality measurement picture. Quality measures that focus on intermediate patient outcomes (such as self-management ability), that follow the patient over time, and that integrate measurement into the processes of care are necessary to move toward a delivery system that is centered on patients.