In recent years, there has been a groundswell among health policy experts, public and private purchasers, and payers toward greater standardization of quality improvement activities. Purchasers increasingly recognize the need for standardization around evidence-based guidelines. Significant movement has occurred in adopting nationally-recognized performance indicators to assess health outcomes. The National Quality Forum and its many partners are establishing national priorities and goals around performance measurement and reporting. National initiatives like Aligning Forces for Quality, the Regional Quality Improvement initiative, and Bridges to Excellence are also helping to align public and private purchasers and payers around uniform quality improvement goals, common performance measures, and, in some instances, common payment.

By jointly developing incentive programs to improve quality at the point of care, purchasers and health plans can replace well-meaning but redundant and often conflicting pay-for-performance (P4P) programs. The resulting standardization of provider incentive programs could dramatically improve physician response to P4P efforts.