The emergence of rating systems—and their use by consumers in making choices—is continuing to grow, and in the continuing policy and payer quest for increased "value" for health and human service dollars, quality initiatives big and small are chipping away at the "cost" part of the value equation. "Value" is the ratio of "quality" to cost. In health and human services, "quality" is an odd combination of clinical quality, system operational performance, customer experience, and customer perception.

As the practices for measuring the performance (both outcomes and service) of health and human professionals, service organizations, and systems evolve . . .

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