Quality of Care in Community Health Centers and Factors Associated With Performance

Federally funded community health centers are a key source of comprehensive primary care for medically underserved communities, serving more than 20 million patients in 2011. The Affordable Care Act (ACA) expanded the health center program significantly to help meet the increased demand for health care that is expected as millions of the uninsured gain health coverage, beginning in 2014. Especially given health centers’ growing role, evidence of the quality of care they provide is of keen interest. Most research shows high performance by health centers relative to various standards, but some gaps have also been found, and suitable benchmarks for assessing the quality of care provided by health centers, which serve a uniquely disadvantaged population, have been lacking. Recently, the Kaiser Commission on Medicaid and the Uninsured (KCMU) partnered with the George Washington University to analyze health center performance relative to Medicaid managed care organizations (MCO), which also serve a low-income population, on important measures of quality of care – diabetes control, blood pressure control, and receipt of a Pap test in the past three years. The study also aimed to identify factors that differ significantly between high-performing and lower-performing health centers. Using data reported in the federal 2010 Uniform Data System (UDS) by health centers and the 2008 Healthcare Effectiveness Data and Information Set (HEDIS) for Medicaid MCOs, we defined health centers as “high-performing” if their rates exceeded the 75th percentile of Medicaid MCO HEDIS scores on all three of our quality measures. We defined health centers as “lower-performing” if their rates were below the mean Medicaid MCO HEDIS score on all three measures