Table 1.

Key take-home points regarding performance outcome measures (POMs) in rheumatology

What are POMs?	POMs are formal tools allowing scientifically valid comparisons of quality of care across providers or to an established benchmark.
Why measure outcomes?	POMs aim to assess what matters most to patients and clinicians and capture the downstream effects of health care processes.
What are the key requirements and trade-offs in developing rheumatology POMs?	Data source: data used to create and report POMs must balance the benefits of detailed, reproducible information with the burden of data collection.
	Measure cohort (denominator): the measure cohort for POMs should accurately and reliably capture the population of interest.
	Reporting period: the reporting period for POMs should consider the measurement goal (e.g., short-term quality improvements or pay for performance).
	Period at risk: the period at risk for POMs should reflect a standard timeframe during which it is reasonable to attribute outcomes to the measured provider or group.
	Measure outcome: the measure outcome for POMs should be unambiguous, be feasible to collect and report, provide meaningful information to providers and patients, and represent an outcome influenced by the health care system or providers being assessed.
	Outcome attribution: the results of POMs should be attributed to the entity most responsible for patient care, while simultaneously recognizing minimum sample sizes needed for stable performance estimates and the multidisciplinary care required for complex chronic rheumatic diseases.
	Risk adjustment: risk adjustment of POMs is critical to ensuring that providers are not penalized for caring for patients at greater risk.
	Reliability and validity testing: POMs should be created from valid, reproducible data and tested to ensure they produce reliable and valid results.
	Implementation and results reporting: reporting of POMs should consider their primary purpose and audience.
What POMs exist in rheumatology?	There are no existing National Quality Forum–endorsed national POMs suitable for the majority of rheumatologists’ patients.
What lies ahead?	POMs are here to stay, and the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers.