Variation in Measure Specifications - Sources and Mitigation Strategies Final Report 

As the U.S. healthcare system has increasingly focused on quality, cost, and efficiency, the use of quality measurement in healthcare has grown rapidly in both scope and importance. This has led to a proliferation of measures across a diverse range of clinical areas, settings, data sources, and programs, and there is growing recognition that performance measures used in various programs are often not well aligned. This project identified reasons for variation in measure specifications and the impact of such variation, as well as provided guidance on ways to mitigate or prevent variation. To do so, the project synthesized available evidence on the phenomenon of variation in measure specifications and proposed standard definitions of key terms used in measure development and implementation, identified the primary causes of variation in a taxonomy, developed strategies and guiding principles to prevent or mitigate negative consequences of variation, and combined all of these elements in a usable framework for measure developers and implementers.