Early experience of the quality improvement award program in federally funded health centers.

ABSTRACT

OBJECTIVES: To describe the Health Resources and Services Administration's Quality Improvement Award (QIA) program, award patterns, and early lessons learned. STUDY SETTING: 1413 health centers were eligible for QIA from 2014 to 2018. STUDY DESIGN: We assessed cumulative QIA funding earned and modified funding excluding payments for per-patient bonuses, electronic health record (EHR) use, patient-centered medical home (PCMH) accreditation, and health information technology. We compared health centers on rural/urban location, PCMH accreditation, EHR reporting, and size. DATA COLLECTION Organizational and quality measures are reported in the Uniform Data System, QIA program data. PRINCIPAL FINDINGS: Average cumulative funding was higher for health centers that were not rural (USD 380,387 [± USD 233,467] vs. USD 303,526 [± USD 164,272]), had PCMH accreditation (USD 401,675 [± USD 218,246] vs. USD 250,784 [± USD 144,404]), used their EHR for quality reporting (USD 374,214 (± USD 222,866) vs. USD 331,150 (± USD 198,689)), and were large (USD 435,473 (± USD 238,193) vs. USD 270,681 (± USD 114,484) an USD 231,917 (± USD 97,847) for small and medium centers, respectively). There were similar patterns, with smaller differences, for average modified payments. CONCLUSIONS: QIA is an important feasible initiative to introduce value-based payment principles to health centers. Early lessons for program design include announcing award criteria in advance and focusing on a smaller number of priority targets.