Performance Measurement for Rural Low-Volume Providers

Challenges such as geographic isolation, small practice size, heterogeneity in settings and patient population, and low case volume make participation in performance measurement and improvement efforts especially challenging for many rural providers. This report presents 14 recommendations from a multi-stakeholder committee that was tasked to address these and other challenges of healthcare performance measurement for rural providers, particularly in the context of the Centers for Medicare and Medicaid Services pay-for-performance programs. The resulting recommendations can help advance the integration of rural providers into CMS quality improvement efforts. The recommendations also can be used to enhance the quality measurement and improvement efforts of other public- and private-sector stakeholders.