In recent years, employers, insurers, and government purchasers have paid increased attention to the measurement of patient outcomes and health status. Such interest is stimulated less by policy or quality concerns than by the need to reduce health care expenditures. Any expected benefits which might accrue from health status measurement will require active participation by community hospitals and their affiliated physicians. St. Vincent Hospital and Medical Center in Portland, Oregon has begun hospital-wide use of outcomes measurement systems. This study presents case studies of outcomes measurement for low back pain and total hip replacement, summarizes the hospital's objectives in implementing such measures, and identifies several strategies for successful adoption of health status measures in community practice.