For some measures, the required period of continuous enrollment is greater. Accessing medical records is costly and time consuming. Medical records may be incomplete and hard to decipher. Encounter data are often incomplete or inaccurate. Claims databases were designed to track the flow of money, not care, and may lack important data elements.
Improvement is always possible, however.
States and others with experience can share lessons learned and examples of progress. The production of performance measures is a data-driven activity. Application to FFS and PCCM programs requires particular attention in early years. In all instances, senior-level agency responsibility and sufficient staff resources are needed to ensure useful results. A committee with expertise on the particular issue.