On the presumption that the proposed bill would mark as "quality care" only those assessments which resulted in a a measurably "positive" improvement on some dimension, what would we learn from data collected on: chronic and relapsing conditions; elder or end-of-life supportive care; emergency or critical interventions to self-destructive and suicidal patients who succumb in spite of efforts;  declining courses of illness which are attenuated or slowed down by treatments; and so on?  Medical necessity for care is not defined by retroactively by "outcome."