Policy analysts have argued that public disclosure of healthcare quality stimulates quality improvements in healthcare delivery organizations. One proposed mechanism for such an effect is the organization’s reputation: Provider organizations improve their quality after public reporting because the reported information affects their reputation. However, research evidence to date is mixed on whether and how reputation affects an organization’s response to public disclosure of health care quality data. Drawing from organizational theory and social psychology literature, this book examines the roles of reputation in organizational response to public reporting of healthcare quality. In particular, it examines whether quality improvement is more likely in organizations whose performance ranking are inconsistent with their prior reputations.