OBJECTIVE: To determine whether a questionnaire that assesses the presence of practice systems is associated with clinical performance rates for diabetes care. STUDY DESIGN: Cross-sectional study of the relation between a survey-based measure of practice systems within 5 of the domains of the chronic care model (CCM) and high-quality care for diabetes during 2005 among 40 medical groups in Minnesota. METHODS: Correlations were calculated between (1) practice systems as measured by the Physician Practice Connections-Readiness Survey (PPC-RS) questionnaire and (2) process and outcome measures of diabetes quality from a standardized system managed by Minnesota Community Measurement. RESULTS: Most process and outcome measures were correlated at 0.31 to 0.52 (P <.05) with the PPC-RS total score as well as with several of the CCM domains. Only yearly eye exams and blood pressure control lacked correlation with any CCM domain, but delivery system redesign and self-management support lacked correlation with quality measures. CONCLUSIONS: As measured by the PPC-RS questionnaire, the presence of practice systems overall and within several domains of the CCM was associated with high-quality care for diabetes. The PPC-RS may be a useful and relatively simple tool for evaluating and guiding improvement of practice systems for diabetes care quality.