Figure 3. Practical consequences of performance misclassification (Text Description)

Figure 3 is a flowchart of various problems resulting from misclassification:

• Lower validity of performance measurement leads to greater share of providers systematically misclassified. Greater share of providers misclassified, overall, which leads to "More patients choose low-performing providers," thinking they are choosing high performers. That results in less patient migration to high-performing providers, leading to greater provider alienation and potential for lawsuits, as well as public reporting efforts being less effective at improving the health care received by the area population.
• Lower reliability of performance measurement leads to greater share of providers misclassified due to chance. Greater share of providers misclassified, overall, which leads to "More providers think they have high performance" when they in fact have low performance, and vice versa. That results in less effective performance improvement efforts by providers, leading to public reporting efforts being less effective at improving the health care received by the area population.
• Greater share of providers misclassified, overall, can also lead to "More providers prioritize the wrong areas for improvement," which results in less effective performance improvement efforts by providers, leading to public reporting efforts being less effective at improving the health care received by the area population.

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