Affordable Care 

Healthcare expenditures in the U.S. are unmatched by any country in the world. Unfortunately, this spending has not resulted in better health for Americans, and in general, the U.S. underperforms compared to other industrialized nations in terms of mortality, patient satisfaction, access to care, and quality of healthcare. Our healthcare spending continues to increase at an unsustainable rate of seven percent per year, and is largely focused on treating acute and chronic illness rather than promoting health and preventing illness and disability.

The National Quality Strategy emphasizes the need to make quality care more affordable for people, families, employers, and governments by focusing on two goals:

  1. Ensuring affordable and accessible high-quality healthcare for people, families, employers, and governments.
  2. Supporting and enabling communities to ensure accessible, high-quality care while reducing unnecessary costs.

Many opportunities exist to address affordability, lower healthcare costs, thereby increasing value and creating a less wasteful healthcare system. In 2012, the Institute of Medicine noted that six factors contributing to excess healthcare costs – unnecessary services, inefficiently delivered services, excess administration costs, prices that are too high, missed prevention opportunities, and fraud – account for approximately $750 billion in spending. Through its endorsement projects, its membership, and its partnerships, NQF is working to address affordability by elevating these issues to the forefront of policy discussions.

Related NQF Work

  • Measuring Affordable Care
    This project will explore what healthcare affordability means from consumer and patient perspectives and to understand what information patients and consumers need to find affordable care.
  • Linking Cost and Quality Measures
    This project will explore current approaches to measuring efficiency and develop best practices for combining cost measures with clinical quality measures to improve efficiency of care.
  • Cost and Resource Use Measures
    This project will seek to recognize and endorse new cost and resource use measures that will facilitate further understanding of the resource use driven by providers and clinicians for the care of patients with various conditions.
  • Episode Grouper Evaluation Criteria
    The project will explore the best approaches for collecting costs information for episodes of care.
  • MAP Families of Measures Report
    Specifically related to the NQF Affordability portfolio, The Affordability Task Force was charged with developing a MAP Affordability Family of Measures. The project selected a suite of measures for value-based purchasing and public programs that may help promote affordability. The Affordability suite of measures can be found in the final report from the Measure Applications Partnership (MAP) that identifies families of measures—sets of related available measures and measure gaps that span programs, care settings, levels of analysis, and populations-related to three National Quality Strategy priorities: Affordability, Person- and Family-Centered Care, and Population Health.

Recommended Reads

Yegian JM, Dardess P, Shannon M et al. Engaged patients will need comparative physician-level quality data and information about their out-of-pocket costs. Health Aff. 2013, 32(2):328-337.

Squires. The road not taken: the cost of 30 years of unsustainable health spending growth in the United States. The Commonwealth Fund Blog, March 21, 2013.

Consumer Beliefs and Use of Information about Health Care Cost, Resource Use, and Value: Findings from Consumer Focus Groups. American Institutes for Research. Publisher: Robert Wood Johnson Foundation Published 10/1/2012

Available at

Physicians' Views of Comparative Information on Costs and Resource Use: Findings and Implications for Report Developers. American Institutes for Research Publisher: Robert Wood Johnson Foundation Published 10/1/2012

Available at

Tell us what you think

What issues related to affordability are you working on? What measures are you using? We want to hear about it.

Please email us about your own efforts to improve affordability at 



NQF Resources

The Field Guide is an online resource designed to help you easily access NQF resources.   

Find Measures

Use NQF's Quality Positioning System (QPS) to find measures related to Affordable Care.

Find measures now! 

Learn from Others

Use NQF's Online Action Registry (OAR) to learn about other efforts in the field to improve affordability. 

Find actions now!