I (Amer) had the privilege to participate in the NQF discussion  about Linking Cost and Quality Measures  on May 1, 2014. Below are my comments to the group.

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Hello, my name is Amer Haider. I am visiting from San Jose, Calif. I am a former technology exec. I left my tech job to start a company that helps patients.
I have 2 analogies from tech that I would like to contribute. I hope my comments provide a patient and public perspective.
My first analogy: The cell phone market has provided higher quality and features with lower costs. 30 years ago most of our cell phone bill was zero. Now all of us are paying $100+/month for cell phones and we are happy. Reducing cost does not equal efficiency. 
Tech markets are extremely efficient because they allow consumer choice and this feedback is utilized to further refine products. 
That being said there are constraints. If I choose to buy Apple vs Samsung i choose various constraints and trade-offs and get very different experience.
I urge the group to look at efficiency in the context of the market and add recommendations to remove restricted patients choice as a key requirement to enable efficiency. 
Feedback on Quality Measurements and Models. 
Open markets have quality measurements. They are determined and prioritized by customers based on the individual’s value. Brands, providers and consumer reports, JD powers, consumer report, Yelp, Us News provide different metrics to help a variety of individuals with different values. 
I think industry groups and governments role is to enforce transparency, and meeting safety guide lines like CE  to enable users to make safe self choice. 
I urge the group to look at metrics that need to be reported that will help people make choices based on their wide range of values
Final I have a cultural point:

When I goto my doctor I feel like am talking to my Dad when I was 10 years old. My doctor wants to choose for me. My point. Please dad tell me what you think is important, give me your experience, let make my choice. I will have to live with it.