Press Release

Embargoed Until Contact

February 15, 2012

Sue Ducat
Director of Communications
(301) 841-9962


From Health Affairs


Evaluating Government-Developed Quality Assessment Tools


Bethesda, MD -- One of the initiatives in the Affordable Care Act of 2010 is the expansion of community health centers to provide primary care to millions of newly insured, low-income Americans. The same law promotes the patient-centered medical home model. A community center’s qualifications to be classified as a patient-centered medical home are evaluated through an assessment tool developed by the National Committee for Quality Assurance (NCQA) and endorsed by the federal government. How well does this tool measure performance on a range of services? A new study, released today as a Web First by Health Affairs, explored that relationship, sampling a group of community health centers in Los Angeles and focusing on diabetes care. It found no significant relationship between how well these centers performed on the assessment and whether they achieved a range of process or outcome measures for diabetes care.

Tool Used To Assess How Well Community Health Centers Function As Medical Homes May Be Flawed
By Robin M.A. Clarke, Chi-hong Tseng, Robert H. Brook, and Arleen F. Brown

All the authors are affiliated with the David Geffen School of Medicine, University of California, Los Angeles (UCLA).

For this study, which will also appear in the journal’s March edition, Clarke was supported by the Robert Wood Johnson Clinical Scholars Program at the University of California, Los Angeles, and Brown was funded by a grant from NIH/NCRR.


Data for the study were collected at thirty community health centers in Los Angeles County, and a total of 1,455 diabetic patients were studied. All of the community health centers studied would have qualified as NCQA patient-centered medical homes. The authors observed substantive differences in the quality of diabetes care across the community health centers, when checking whether patients had received standard diabetes care evaluations, such as blood pressure, HbA1c, or LDL-c testing; kidney disease screening; or eye examinations. However, the presence of more NCQA patient-centered medical home components was not associated with better delivery of diabetes care measures. “One explanation is that the NCQA tool does not measure the processes that determine the quality of diabetes care with enough sensitivity for a community health center,” conclude the authors. They suggest that future demonstration projects “evaluate how effective enabling services are at overcoming barriers to care and improving chronic disease outcomes.”

About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.

The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.