Researchers and policymakers have publicly discussed and debated whether or not to adjust provider quality measures for differences in patient characteristics. Lacking in this discussion, however, is a nuanced understanding of how adjustment should be conducted within a rural context and what impact it might have on patients and providers when quality measures are used for benchmarking and payment.

The purpose of this project was to identify how rurality and key sociodemographic variables might affect quality-of-care outcomes and to estimate the potential impact on quality measurement.