The report card concept does not connote a single instrument used for a single purpose, or for all instances of outcomes data reporting. Uniquely defined report cards can be useful to organizations and their stakeholders. Health care executives competing for marketshare in an era of negotiated prices and payor-controlled access to healthcare services must provide information about clinical outcomes, cost-effectiveness, and organizational performance to those who are responsible for selecting health providers or health plans. The organization's leaders must view the reporting process as important from a strategic perspective, and establish processes and allocate resources to produce a report in an efficient and cost-effective manner that will meet the information needs of key stakeholders. Developing useful outcomes report cards will require collaboration among many individuals in an organization, and perhaps collaboration among organizations in a market area. Expected benefits to the organization include improvement in stakeholder relationships, which might be measured through increased market share. The proposed implementation model is based on a synthesis of processes and recommendations reported in the literature extended by information from an in-depth case study. Problematic issues with outcomes data and public reporting have been considered. Although the model is derived from a conceptual and research base, it is both pragmatic in design, and solution- centered. Research questions for future empirical research might include the following: Which stakeholders are appropriate recipients of what types of information? How do different stakeholders evaluate the relative importance of each type of information? Which reporting formats are more appropriate for which stakeholders? What effect does a truncated decision-making process (such as the one described here) have on the effectiveness of the decision- making process? How effective are report cards in marketing the institution's services (i.e., to what degree to stakeholders respond to the data)?.