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39Yet the availability of these tools is still quite limited in the population as a whole, and many 19
Americans are not aware of their features and benefits. Strategies for promoting awareness of tools are needed to stimulate their demand and use. Involving patients and families at the various levels described earlier will also lead to increased pressure for organizational responsiveness to the need for patient-centered care. Public Reporting of Standardized Measures.The importance of systematic measurement and feedback to achieving patient-centered care was noted earlier. Such measures are useful not only for monitoring and guiding improvement within organizations, but for holding organizations accountable for their results through public reporting. Ideally, such measurement and reporting should be based on the best available scientific evidence and standardized to enable fair and accurate comparisons within and across organizations and practitioners. Building on the foundation established by the original Picker surveys, the evolving CAHPS suite of standardized instruments for assessing the patient experience now spans the continuum of care, including health plans, medical groups, individual physicians, in-center hemodialysis centers, hospitals, nursing homes, home care services, and assisted living facilities.40The Centers for Medicare and Medicaid Services (CMS) publicly reports data from many of the CAHPS surveys on its Web site, and is planning to report results from national implementation of the CAHPS Hospital Survey in March of 2008. A number of regional initiatives, such as the Massachusetts Health Quality Partners and the Pacific Business Group on Health, are also publicly reporting patient experience survey data to help consumers make informed choices about providers. A limited but growing body of evidence suggests that public reporting of quality measurements creates strong incentives for organizations to improve their performance.41The effectiveness of these data for supporting consumer choice of health care providers is less clear.42However, the experts interviewed for this project agree that the public reporting of patient-centered care measurements will play an increasingly powerful role in stimulating organizational change, especially as they are incorporated into various pay-for-performance schemes designed to link either cash payments or market share to comparative levels of performance. Accreditation and Certification Requirements.Accreditation and certification programs have historically provided significant external incentives for health care organizations to improve. Increasingly, these programs are building measurements of patient-centered care into their process. For example, the National Committee for Quality Assurance (NCQA) is exploring how measurements of patient-centered care might be built into a physician quality recognition program, in which physicians or physician groups interested in seeking recognition submit the required data to NCQA for scoring against predefined standards.