Hundreds of the nation's nearly 1,200 community health centers, which serve millions of mostly poor people, fall short on key measures such as vaccinating children and helping diabetics control blood sugar, federal data show.
More than 20 million sought care at the non-profit, largely private centers last year -- double from a decade ago. The centers are poised to take an even more central role in the U.S. health system if President Obama's health law is upheld by the Supreme Court, because it would give 30 million people health coverage starting in 2014.
An analysis of 2010 center data by Kaiser Health News and USA TODAY shows:
Centers in the South generally rated lower than those in New England, the Midwest and California.
Nearly 75% of the centers performed significantly worse -- at least 10% below the national average -- in screening women for cervical cancer. The national average reflects the care of all Americans.
About 73% performed significantly below average in maintaining diabetics' blood sugar.
Roughly 28% performed significantly below average for immunizing 2-year-olds.
"We feel good about quality overall, but there is clearly room to improve," says Jim Macrae, who oversees the health centers for the U.S. Health Resources and Services Administration.
Consumer advocates worry about the impact on patients.
"We have so many uninsured for whom the community health centers are one of the few places where they can go for primary care," says Cindy Zeldin, executive director of Georgians for a Healthy Future.
Macrae points out that some centers do better than the national average in certain areas. For instance, three out of four centers performed significantly better in helping hypertensive patients keep their blood pressure under control, and more than four in 10 do significantly better in making sure women get timely prenatal care.
The centers face greater challenges than the average doctor's office because their patients are nearly six times as likely to be poor.
Georgia was the only state to rank near the bottom on four of the six performance measures the federal government collects from clinics. Four other states -- Louisiana, Virginia, Kansas and Kentucky -- ranked near the bottom for three measures.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a non-profit, non-partisan health policy research and communications organization not affiliated with Kaiser Permanente
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