Uniform Data System (UDS) Health Center Adjusted Quartile Ranking

The Program Grantee Profiles report contains a column that provides a health center’s adjusted quartile ranking compared to health centers nationally for each of the clinical performance measures. Clinical performance for each measure is ranked from quartile 1 (highest 25% of reporting health center) to quartile 4 (lowest 25% of reporting health centers).
Adjusted quartile rankings differ from rankings based on actual performance on specific measures. The adjusted quartile assesses a health center’s clinical performance compared to other health centers, while accounting for specific differences in health center characteristics. These characteristics include:

  • Percent of uninsured patients
  • Percent of minority patients
  • Percent of homeless patients
  • Percent of farmworker patients
  • Electronic Heath Record status (EHR) (non EHR = sample of 70 patient records, EHR = all patient records for the measure)

The purpose of the adjusted quartile rankings is to provide health centers with information on their relative performance compared to other health centers on the national Uniform Data System (UDS) clinical measures after adjusting for certain health center characteristics. The above factors are used to adjust rankings for the following clinical measures:

  • Childhood Immunization
  • Diabetes Control
  • Hypertension Control
  • Pap Test
  • Children (Ages 3-17) Receiving Weight Assessment & Counseling
  • Adults (Age 18+) Receiving Weight Screening & Follow-up
  • Adults (Age 18+) Receiving Tobacco Use Assessment and Cessation Intervention
  • Asthma Patients (Age 5-40) Receiving Pharmacologic Therapy
  • Coronary Artery Disease Receiving Lipid Therapy (18+)
  • Ischemic Vascular Disease (IVD) Receiving Aspirin Therapy (18+)
  • Colorectal Cancer Screening  (Ages 51-74)
  • HIV Linkage to Care
  • Depression Screening and Follow-up (Age 12+)
  • Children (Age 6-9) Receiving Dental Sealant to First Molars

EHR status is not relevant for the two measures on which all patients are reported: access to prenatal care and low birth weight. Adjusted rankings for these measures are based on the first four patient factors.
A health center should expect to see a higher ranking if they perform above what is predicted for a health center with similar characteristics based on these adjustments. Conversely, a health center should expect to see a lower ranking if they are performing below what is predicted for a health center with similar characteristics. The health center will then know their ranking relative to other health centers nationwide.


Adjusted quartile rankings do not replace the actual performance rates for the UDS clinical measures that have been reported since 2008. Actual performance rates should continue to be used by health centers for quality improvement purposes and will be used by BPHC to assess health center performance over time. 
Reporting health centers will receive their own adjusted rankings. If a ranking is identified as an outlier, the affected health center will not receive the ranking for that measure. This outlier exclusion has no negative implication, only that the adjusted quartile ranking in question is considered to be a statistical anomaly.    
The method for making ranking adjustments will be evaluated by BPHC and additional refinements will likely occur to further improve the adjusted rankings.    


Date Last Reviewed:  November 2018

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