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.
- 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
- 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.