This Joint Commission annual report describes performance data for United States hospitals across a large number of evidence-based measures, referred to as accountability measures. The report highlights 2015 as a year in which The Joint Commission implemented many changes. Given excellent performance by hospitals in previous years and to align more closely with the Centers for Medicare and Medicaid Services Hospital Inpatient Quality Reporting Program, The Joint Commission decreased the number of accountability measures from 49 to 29. The percent of hospitals that performed at 95% or above for all accountability measures declined from 80.3% in 2014 to 61% in 2015. However, the report emphasizes that many of the measures in which hospitals were performing extremely well were among those that were removed, and hospitals continued to improve on individual accountability measures. In addition, The Joint Commission introduced flexible reporting options giving hospitals some choice in which metrics to report. Hospitals were also given the opportunity to submit electronic clinical quality measure data for the first time. A previous WebM&M commentary discussed the unintended consequences of public reporting of hospital quality.