Assesses the potential of a diverse set of Rural Health Clinics to comply with the quality assessment and performance improvement program (QAPI) requirements and the capacity of state agencies to provide RHCs with technical assistance in their QAPI implementation. Finds that more information and guidance on QAPI requirements is needed to make the program a success, and that to make QAPI useful to RHCs, RHCs need technical assistance in all aspects of quality assurance. Also finds that QAPI implementation could hamper care in resource-strapped RHCs if implementation is too costly or if clinics decide to withdraw from the RHC program because of QAPI.