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Binder has led initiatives to improve safety and quality in hospitals, including the Hospital Safety Grade that assesses the safety of hospitals across the country. Since last year, Leapfrog continues to work with CMS on value-based programs. Leapfrog recently said it first report of outpatient settings found outpatient care lags in quality practices. Binder said that there is little data available about outpatient and ambulatory settings, "We believe purchasers and consumers deserve to have this information to make informed decisions."