Quality of care measurement and reporting at the provider, hospital, or health system level has become increasingly common in health systems around the world. Health system performance reports, whether they be confidentially distributed to the provider or made available to the public, are not only used as a stimulus for quality improvement, but can also be used to inform policy, apportion funding, or in rare cases, punish poorly performing providers. In this review, we outline several principles of quality of healthcare measurement and performance reporting, and describe a framework for optimal performance reporting that provides the greatest opportunity for the desired outcome-health system improvement. The quality reporting framework and roadmap that we present invokes opportunities for improving care in the domain of surgical oncology.