Producing Public Reports of Physician Quality at the Community Level: The Aligning Forces for Quality Initiative Experience

Objectives: To describe the approaches used by the Aligning Forces for Quality (AF4Q) alliances in producing community-based reports of physician quality and to assess the contribution of these reports to existing physician performance information. Study Design: The study included semi-structured interviews with alliance stakeholders and tracking of the number and content of physician performance reports in 14 AF4Q initiative communities and 7 comparison communities. Methods: The study used qualitative analysis of interview data and systematic tracking of the number and content of physician performance reports over time. Results: Report production occurred in several stages including initiation, measure selection/specification, measure construction, and dissemination. The measure selection/specification process was often the first major act undertaken by alliances under the AF4Q initiative grant. Alliances utilized nationally endorsed performance measures and made a strategic decision to gain buy-in with physicians. Alliances have experienced greater difficulty in producing buy-in for patient experience measures. The primary decision point for measure construction was the use of administrative claims data or physician-provided medical records data. Overall, AF4Q alliances have contributed to an increase in physician performance information in their communities. Conclusions: Our findings suggest that the AF4Q initiative has accelerated the development and content of physician performance measures in AF4Q communities. (Am J Manag Care. 2012;18:S133-S140)