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J Ambul Care Manage. 2008 Apr-Jun;31(2):111-9. doi: 10.1097/01.JAC.0000314701.50042.0b.

The perceived financial impact of quality improvement efforts in community health centers.

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National Opinion Research Center, Washington, DC, USA.


We administered surveys to 100 chief executive officers (CEOs) of community health centers to determine their perceptions of the financial impact of the Health Disparities Collaboratives, a national quality improvement initiative. One third of the CEOs believed that the HDC had a negative financial impact on their health center, and this perception was significantly correlated with centers having a higher proportion of uninsured patients. Performance-based payment incentives may improve care but may also add new financial burdens to facilities that treat the uninsured population. As such, a provider's payer mix may need to be considered in the design of QI programs if they are to be sustainable.

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