Pilot Testing a Rural Health Clinic Quality Measurement Reporting System


More than 4,000 Rural Health Clinics (RHCs) serve the primary care needs of rural communities, and are therefore an important source of primary care and other essential health services for rural residents. Unfortunately, the Rural Health Clinic Program is plagued by a lack of data on the financial, operational, and quality performance of participating clinics. In light of the significant expansion of quality performance reporting and growing use of performance-based payment approaches, it is critically important that RHCs be able to compete in this changing healthcare market. To this end, we piloted the reporting and use of a small set of primary care-relevant quality measures by a geographically diverse sample of RHCs. This policy brief reports on the results of this pilot with a focus on assessing the feasibility and utility of the reporting system and quality measures for the participating RHCs.

Key Findings:

  • A core set of RHC quality measures should focus on key RHC clinical issues including diabetes, blood pressure control, immunizations, medication management, and tobacco use interventions.
  • Key elements of a successful RHC quality measurement reporting and benchmarking system include easy to use data entry and analysis tools, technical support for data entry and use of the quality measures, ability to benchmark against relevant peer groups, and opportunities to collaborate and share learning in tackling clinical and quality issues.
  • Participants in the pilot primarily used the quality data for internal quality improvement efforts rather than for public reporting and noted improved quality performance.
  • Commonly reported barriers/challenges to using the quality measures set include extracting data from the clinic's EHR, the limited availability of staff time to collect data and report on the measures, and the overall reporting burden on the clinic.
  • Ongoing identification and dissemination of the lessons learned from RHCs already participating in quality reporting and benchmarking initiatives are needed to support RHCs in coping with growing policy pressures to report quality data.
Maine Rural Health Research Center
John Gale, Anush Hansen, David Hartley, Andrew Coburn