Missouri law has demonstrated the importance of quality measurement and reporting.  Primarily, the law requires health insurers, including health maintenance organizations, and providers to provide data on quality of patient care and patient satisfaction to the Department of Insurance.  Furthermore, the law states that failure to provide this information will lead to an unfair trade practice violation.1  Health maintenance organizations may also be designated community-based, if they meet certain criteria, including performance improvement, and increases in the quality and access to health care within the community.2

        In addition, Missouri requires all of its Medicaid plans to enroll in a health improvement plan and its Medicaid patients to be provided a health home.  The law requires the Department of Social Services to evaluate the health improvement plans based on cost, quality, health improvement, outcomes, health status, patient satisfaction, use of evidence based medicine, and use of best practices.3

        Hospitals are also required to have an ongoing, hospital-wide, patient oriented performance improvement plan that measures, assesses, and improves the quality of health care provided to patients.4