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This approach is very similar to comparing each entity’s scores to the highest possible performance. Once again, you have to decide whether you will only consider the performance within your own community, or also consider performance from entities in other parts of the State or Nation.

Advantages of Comparing to a Top Percentile

• It sets a higher bar than an average.
• It signals to the community that the sponsor is “shooting for the stars.”
• Providers and plans may be somewhat less resistant, especially if comparisons are internal only, since it is then inevitable that some entities will be in the top 10 or 20 percent. Lower performers may even reach out to the higher performers to learn how they are achieving their scores.

Disadvantages of Comparing to a Top Percentile

• It is difficult to display and explain this approach to consumers, especially if you attempt to use an unfamiliar term like “percentile distribution.”

Also in "Choosing a Comparator"

• Comparing Health Plans and Providers to Each Other
• Comparing to a State or National Average
• Comparing to a Benchmark (the Highest Performance Achieved)
• Comparing to the Top 10 or 20 Percent of Performers
• Comparing to an Independent Standard