Quality Measurement: Key Terms and Definitions

Achieving the best outcomes for persons receiving health care or support services is a shared goal of the persons served and their families and friends, clinicians, direct support workers, administrators, payers, policymakers, and researchers. Yet each of these interested parties brings different perspectives when defining, measuring, and prioritizing outcomes. In this Special Communication, we describe and define key quality measurement concepts, frameworks, and terminology used in the Centers for Medicare & Medicaid Services' quality programs. We describe commonly used frameworks, including Donabedian's framework, the Institute of Medicine's aims of health care as detailed in Crossing the Quality Chasm, and a modification of the National Quality Forum's conceptual framework for high-quality home- and community-based services. We also define the terms "quality," "quality measure," "outcome measure," "performance measure," and "risk adjustment." This information is intended to help readers better understand quality measurement terminology used by the Centers for Medicare & Medicaid Services. We hope that this information will support productive communication among interested parties about quality measurement in ways that advance quality in inpatient rehabilitation facilities and home- and community-based services.