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Performance Measures for Contraceptive Care

A New Tool to Enhance Access to Contraception

Moniz, Michelle H., MD, MSc; Gavin, Loretta E., PhD, MPH; Dalton, Vanessa K., MD, MPH

doi: 10.1097/AOG.0000000000002314
Contents: Current Commentary

Contraception is an essential health service for reducing unintended pregnancy rates, improving health outcomes, and reducing health care costs. However, contraceptive services may not consistently provide access to the full method mix and to patient-centered care. Improving the quality of contraceptive care is a critical strategy to improve contraceptive use, health outcomes, and the patient experience of care. We here describe the three National Quality Forum–endorsed performance measures for contraceptive care, which are intended to monitor 1) provision of most and moderately effective methods, 2) access to long-acting reversible contraception, and 3) provision of most and moderately effective methods and access to long-acting reversible contraception after childbirth. These contraceptive care measures are designed to ensure that contraceptive care is accessible and offers the full spectrum of methods. Payers, health care systems, public agencies, and researchers could all monitor these performance measures for different populations. We describe the crucial role of clinicians in disseminating and using the contraceptive care performance measures for quality improvement. We describe ongoing efforts to improve contraceptive care quality, including the development of measures to monitor other dimensions of quality such as the safety and patient-centeredness of care. Thirty-eight million women at risk of unintended pregnancy are counting on us to improve the quality of family planning care in the United States and ensure that all women have the resources and tools to make free, informed choices about whether and when to become pregnant.

New National Quality Forum–endorsed performance measures for contraceptive care hold promise to help clinicians, health care systems, and policymakers monitor and improve the quality of contraceptive care.

Department of Obstetrics and Gynecology, the Program on Women's Healthcare Effectiveness Research, and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.

Corresponding author: Michelle H. Moniz, MD, MSc, Department of Obstetrics and Gynecology, 2800 Plymouth Road, Building 14, Room G222, Ann Arbor, MI 48109-2800; email:

Financial Disclosure Dr. Dalton is a paid expert witness for Bayer Corporation. The remaining authors did not report any potential conflicts of interest.

The authors thank Renuka Tipirneni, MD, MSc, for insightful comments on an earlier version of this manuscript and Sarah Block for assistance with manuscript formatting.

Loretta E. Gavin was employed by the U.S. Department of Health and Human Services Office of Population Affairs during the drafting of the manuscript. The views expressed here are the authors' own and do not necessarily reflect the views of this office.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.