In early May I attended the NQF meeting about linking healthcare cost and quality with efficiency. Below are my comments to the group after attending a full day or meetings.

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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 an analogy from tech world 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/user 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 unrestricted patient choice as a key requirement to your recommendations
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 guidelines like CE. In this role the government enables users to make safe self choices. 
I urge the group to look at metrics that need to be reported to help people make choices based on their wide range of values
Finally 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.