An experiment was performed in California and Minnesota from 2014 to 2016 to formulate a method to assess the rank health care systems on the basis of ambulatory care quality.

55 participating healthcare systems were ranked based on public datas on quality of ambulatory care. It did not necessarily need the healthcare systems to report every measure. The various parameters’ suitability were evaluated by assessing whether it complied to the quality dictated by the component measures, whether different healthcare systems correctly correlated to their statistical rankings (reliability), and whether annual fluctuations in their ranks were minimal (stability). 

The composite result was found to be largely dependent on all the individual component measures and was not determined by any particular measure. The ranking system was found to be reliable as the ranks for 93% of California systems and 80% of Minnesota systems had shown movement less than 2 places. The measure was also stable as less than 50% of systems were reduced by more than 2 ranks annually. 

To conclude, this composite evaluation used publicly reported data to assess the validity, reliability, and stability in the ranks of healthcare systems, and this approach can be successfully implemented in other situations too.