“What gets measured gets done” is an all-too-familiar doctrine in Washington among health policy experts in their quest to leverage payment to evidence of value. This linkage was strengthened on November 27, 2013, when the Centers for Medicare & Medicaid Services (CMS) released its 2014 Physician Fee Schedule (PFS). Its focus on quality reporting has far-reaching implications for all medical specialties.

The quality movement was first introduced in manu-facturing nearly 50 years ago with the teachings of W. Edwards Deming, Philip B. Crosby, Joseph M. Juran and others. It has gone through several iterations, including Total Quality Management, Continuous Quality Improvement and its more recent relatives in ISO 9000, Lean Manufacturing and Six Sigma. The quality movement has migrated to most industries and has spawned the development of associations, professions and recognition, such as the Malcolm Baldrige National Quality...

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