The medical deficiency report (MDR) identifies quality measures for each disease state and lists by individual what deficiencies exist.  The MDR can compare patients in the disease management program with those not in the program from a clinical as well as financial viewpoint.  It can also evaluate physicians or care managers, such as pharmacists or nurses, that are involved in patient care regarding clinically appropriate treatment.  The identification process is based minimally on medical and pharmacy data, but it can also include laboratory testing and health risk assessments.  MDRs are comprehensive and used to generate the patient progress report (PPR).  The PPR is a working document for individual practitioners of patient care.  Each patient visit will be tracked so as to document the progress achieved since the previous session, therefore measuring quality of care each month.  The MDR and PPR “level the playing field” with respect to the quality of care provided for each patient.  Success of the programs is enhanced because compliance and achievement of goals are rewarded.