Public reporting and pay-for-performance programs in perioperative medicine: are they meeting their goals?

Public reporting and pay-for-performance reimbursement are two strategies designed to stimulate hospital quality improvement. Information about the quality of hospital care (including surgical volumes and staffing, process-based measures, and mortality and other outcomes) is compiled on various Web sites, giving the public means to compare providers. While public reporting has been shown to foster quality-improvement activities by hospitals, its effects on clinical outcomes are less certain. Likewise, consumers' awareness and use of publicly available hospital and provider quality data have been low but appear to be increasing.