Practice Notes

Paralyzed by performance data? Streamline your scorecard.

Tiffany Chan

As hospitals and health systems take on new, performance-based contracts, medical group leaders find themselves generating what some call "Holy Grids"—long lists tracking each payer’s disparate metric requirements.

Not only can these grids overwhelm the medical group administration responsible for managing them, they can also frustrate clinicians who struggle to keep track of the many performance measures for which they are held accountable.

Medical group leaders, faced with the contradictory demands of hospital partners pushing to track more metrics and physicians urging for a simplified list, can use a streamlined scorecard to achieve both strategic and management goals.

Two tips for building a manageable metric list

Groups managing multiple risk-based contracts often face "analysis paralysis"—diffusion of both managers' and clinicians' attention among disparate goals and dozens, sometimes even hundreds, of metrics. Our study on executive dashboard design offers two principles for making metric lists more effective.

  • The Metric Selection Toolkit

    Building Actionable Performance Dashboard provides a proven framework for selecting dashboard indicators, including a vetted list of 100 metrics available in the downloadable study appendix.

Keep it simple

Long metric lists can obscure the most important performance goals. Some of the most successful “care transformation” innovators have developed concise scorecards with no more than 30 metrics. Although metrics vary across groups depending on their broader strategy, there are four filters you can use to select the right ones.

Your electronic medical records (EMRs) can be your medical group’s greatest tool or biggest set-back in the quest for a concise set of defensible metrics. EMR databases enable groups to drill down on clinical cost and quality information. At the same time, the firehose of data available through EMRs ironically tempts groups into tracking more data, which can crowd out key performance metrics.

Align performance metrics to strategic goals

Groups should continually evaluate metric lists against their own strategic priorities and prune these lists to reflect evolving priorities and performance. Tighter alignment ensures that group management promotes institutional goals.

A less obvious benefit to the group is the opportunity to "upwardly manage" payer and strategic priorities. In fact, some organizations have used their condensed sets of metrics to develop a simplified risk contracting strategy, only accepting contracts that align with predetermined metrics.

Learn More

Which metrics is your organization tracking? Let us know by emailing us at

For guidance on developing executive dashboards that demonstrate medical group value to health system executives and guide management, see our related study. In particular, the Metric Selection Toolkit provides 100 vetted metrics culled from high-performing executive dashboards.