Through the measurement of performance in providing inmate medical care, correctional administrators are better able to show policymakers the cost-effectiveness of inmate medical care when competing for scarce resources; however, there are current and future challenges in this endeavor. Increasing inmate populations with high rates of significant diseases, coupled with the high cost of medical care, make it difficult for governments to fund a full-continuum, state-of-the art inmate healthcare system that meets strict performance standards. This effort is further complicated by the absence of a universal, national policy that drives public policy on inmate healthcare; a bias against providing inmates a quality of medical care that many law-abiding citizens cannot afford; the difficulty of continuing medical care after an inmate's release; and inadequate technological support for effective performance measurement. In spite of these many challenges, the move toward performance-based standards in inmate medical care can improve such services and provide a model for medical care in both the corrections system and the community. This article provides guidelines for developing performance measures for medical services. It advises that good performance measures should be goal-focused, feasible, understandable, precise, accurate, valid, project-linked, and meaningful. Once such performance measures have been developed, there must be technological support for the collection, analysis, management, and reporting of data directly related to performance standards. 6 notes