IHA started the first small hospital quality indicator reporting system in our state approximately eight years ago. This system allows hospitals to report on a real-time basis a variety of indicators which they select from a menu. Originally put in place with five indicators, the system now supports reporting, tracking and trending of 32 indicators. Participating hospitals get graphs and charts showing how they compare with other hospitals on a monthly basis. This system was expanded to support Blue Cross of Idaho's "Pay for Performance" initiative. Patient safety and hospital reimbursement have both benefited from IHA's forward thinking in this area.