The goal of assessing health care quality is to recognize gaps in performance and identify opportunities for improvement that will increase the health of individuals and society. The complexity inherent in health care systems, health care delivery and humans themselves, requires the development of complex measurement systems. However, greater complexity in measurement comes at a cost. In this work, the impact of data quality and limitations in the resources necessary to ensure accurate and reliable measurement through risk adjustment are explored. A new metric for ranking risk adjustment...