- What is the health center adjusted quartile ranking?
The adjusted quartile is an ordering of health centers’ clinical performance compared to other health centers on the clinical quality measures (CQMs) that are reported to the Uniform Data System (UDS) annually. The ranking is adjusted to account for factors that may influence performance outcomes, such as:
- Percent of patients who are uninsured
- Percent of minority patients
- Percent of patients experiencing homelessness
- Percent of patients who are migrant and seasonal farmworkers
- Electronic Health Record (EHR) status
Clinical performance for each measure is ranked from quartile 1 (highest 25% of reporting health centers) to quartile 4 (lowest 25% of reporting health centers).
The health center should expect to see a higher ranking if their performance is above what is predicted for a health center given similar characteristics. The purpose is to provide reporting health centers with additional information so they can compare their performance on specific CQMs to other health centers. See the Health Center Adjusted Quartile Ranking page for more information.
- Where can I find my health center’s AQRs?
To view health center AQRs, you can either:
- Download the Health Center Performance Comparison Report from the HRSA Electronic Handbooks.
- View Health Center Profiles on the Health Center Program Data System (UDS) Data Overview page and select “Clinical Data.”
- Why is there a change from the health center percentile to the health center adjusted quartile?
The adjusted quartile is meant to assess health center clinical performance after taking into account (or adjusting for) selected factors: percent of uninsured, minority, and special population patients as well as EHR status. The health center adjusted quartile controls for certain differences between health centers. It is provided to inform reporting health centers of their relative standing compared to other health centers after adjusting for selected center-specific differences.
- How were the health center factors chosen for adjustment?
The factors chosen for adjustment are characteristics that vary among health centers; research shows that they are significantly associated with differences in clinical performance. These factors include percent of uninsured, minority, and special population patients and EHR status.
- My health center’s clinical quality measure for controlling high blood pressure is 39.0%, yet the health center adjusted quartile is 1. Why is my health center’s adjusted quartile ranking in the first quartile?
The difference in clinical performance and health center adjusted quartile arises from variations across health center patient composition (percent of uninsured, minority, and special population patients) and EHR status. The adjusted quartile can result in a higher rank if the health center performs better than expected, or above average, relative to other health centers with similar characteristics.
- How should the health center adjusted quartile be interpreted?
The adjusted quartile is provided for informational purposes only and does not change or replace the health center’s reported clinical performance. Adjusted quartile rankings can be used for comparisons to peers, but health centers should use actual (unadjusted) performance rates for their own quality improvement efforts. BPHC also uses actual performance rates to assess health center performance on their CQMs over time.
- Can my health center move from a lower AQR to a higher AQR?
Since the AQR measures are based on the most currently available UDS data, the thresholds between adjusted quartiles may not be consistent year-to-year. Therefore, HRSA is unable to determine what percentage point improvement would be needed to move between quartiles for a given CQM between UDS reporting years.
Adjusted quartile ranking can be used for comparison to other HRSA-funded health centers, but HRSA recommends health centers use actual (unadjusted) performance rates for their own quality improvement efforts. CQM values for all HRSA-funded health centers are available in the downloadable full UDS datasets on the HRSA Electronic Reading Room page.