The United States of America is consuming more than 13 percent of the gross national product in health care. The health care consumers, payers and providers want value for their health care dollar, and that means they need information on cost and quality of care. The Joint Commission on Accreditation of Health Care Organizations launched its Agenda for Change in 1986 in an effort to convert the accreditation process from structure to performance focused standards. Now, the Joint Commission has a new set of indicators that have undergone rigorous testing. The Joint Commission stimulates and facilitates quality, as well as recognizes that Continuous Quality Improvement is just one of many means to improve performance.