This brief provides lessons from communities involved in Aligning Forces for Quality, the Robert Wood Johnson Foundation’s signature effort to lift the quality of care in America. Public reporting is a cornerstone of the Aligning Forces for Quality program. This brief focuses on the evolving process of public reporting and the challenges associated with adding cost and efficiency measures to reports of quality performance data. A subsequent brief, “Lessons in Performance Measurement: A Community Approach to Reducing Readmissions,” will look at readmission rates, one of the most commonly reported cost and efficiency measures.