This paper will attempt to outline the issues surrounding performance measurement and public reporting of health care quality information. After giving some history and background on quality improvement in general, it will go on to describe in greater detail the developing field of outcomes measurement and management, with particular focus on methods of risk-severity adjustment for addressing case-mix of hospitals. The second part of the paper will describe and compare various state and regional efforts at reporting hospital outcomes data as a backdrop for a discussion of similar efforts currently underway in Texas. It will describe the formation of the Texas Health Care Information Council in 1995, including its efforts to date attempting to develop a health care information plan for Texas. Finally, it will discuss the policy issues surrounding public disclosure of health care information in general, and specifically the barriers to effective public health care information management in Texas. Finally, it will make recommendations for further development of a health care information infrastructure.