Lee Goldman|Philip Chu|H??ng Thanh Tr?n|Max J. Romano|Randall S. Stafford
Federally Qualified Health Centers and Private Practice Performance on Ambulatory Care Measures
University of California, San Francisco|University of California, San Francisco|University of California, San Francisco|Johns Hopkins University|Johns Hopkins Medicine|Stanford University
background 2010 affordable care act relies federally qualified health centers fqhcs fqhc lookalikes lookalikes provide care newly insured patients ties increased funding demonstrated quality efficiency purpose compare fqhc lookalike physician performance private practice primary care physicians pcps ambulatory care quality measures methods study crosssectional analysis visits 20062008 national ambulatory medical care survey performance fqhcs lookalikes 18 quality measures compared private practice pcps data analysis completed 2011 results compared private practice pcps fqhcs lookalikes performed better six measures p005 worse diet counseling atrisk adolescents 26 vs 36 p005 differently 11 measures higher performance occurred ace inhibitors use congestive heart failure 51 vs 37 p0004 aspirin use coronary artery disease cad 57 vs 44 p0004 blocker use cad 59 vs 47 p001 use benzodiazepines depression 91 vs 84 p0008 blood pressure screening 90 vs 86 p0001 screening electrocardiogram ekg avoidance lowrisk patients 99 vs 93 p0001 adjusting patient characteristics yielded similar results except private practice pcps longer performed better measures conclusions fqhcs lookalikes demonstrated equal better performance private practice pcps select quality measures despite serving patients chronic disease socioeconomic complexity findings provide policymakers reassurance quality chronic disease preventive care federally qualified health centers lookalikes plan use health centers serve 20 million newly insured individuals 2010 affordable care act relies federally qualified health centers fqhcs fqhc lookalikes lookalikes provide care newly insured patients ties increased funding demonstrated quality efficiency compare fqhc lookalike physician performance private practice primary care physicians pcps ambulatory care quality measures study crosssectional analysis visits 20062008 national ambulatory medical care survey performance fqhcs lookalikes 18 quality measures compared private practice pcps data analysis completed 2011 compared private practice pcps fqhcs lookalikes performed better six measures p005 worse diet counseling atrisk adolescents 26 vs 36 p005 differently 11 measures higher performance occurred ace inhibitors use congestive heart failure 51 vs 37 p0004 aspirin use coronary artery disease cad 57 vs 44 p0004 blocker use cad 59 vs 47 p001 use benzodiazepines depression 91 vs 84 p0008 blood pressure screening 90 vs 86 p0001 screening electrocardiogram ekg avoidance lowrisk patients 99 vs 93 p0001 adjusting patient characteristics yielded similar results except private practice pcps longer performed better measures fqhcs lookalikes demonstrated equal better performance private practice pcps select quality measures despite serving patients chronic disease socioeconomic complexity findings provide policymakers reassurance quality chronic disease preventive care federally qualified health centers lookalikes plan use health centers serve 20 million newly insured individuals