Accounting for Social Risk Factors in Medicare Payment (2017) / Chapter Skim
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D1: Introduction
D1: Introduction
Pages 475-480
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From page 475... ...
Because current VBP programs do not account for social risk factors for poor health outcomes, these programs may underestimate the quality of care provided by proiders v disproportionally serving socially at-risk populations. Consequently, these providers may be more likely to fare poorly on quality rankings ( erenson B and Shih, 2012; Elliott et al., in press; Gilman et al., 2014, 2015; Joynt and Jha, 2013a; Rajaram et al., 2015; Shih et al., 2015; Williams et al., 2014)
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From page 476... ...
Opponents are concerned that methods like risk adjustment could obscure real disparities and thereby reduce incentives to improve care and reduce health disparities. Thus, they might argue that providers disproportionately serving socially at-risk populations should be held responsible for providing services in a manner that compensates for social risk factors.
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From page 477... ...
In the first report, the committee presented a conceptual framework and described the results of a literature search linking five social risk factors and health literacy to health-related measures of importance to Medicare quality measurement and payment programs. In the second report, the committee reviewed the performance of providers disproportionately serving socially at-risk populations, discussed drivers of variations in performance, and identified six community-informed and patient-centered systems practices that show promise to improve care for socially at-risk populations.
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From page 478... ...
• dentify methods that could be used in the application of SES factors and I other social factors to quality, resource use, or other measures used in Medicare payment programs. The fourth report will: • or each of the SES factors or other social factors described above, recom F mend existing or new sources of data on these factors and/or strategies for data collection, while also identifying challenges to obtaining appropriate data and strategies for overcoming these challenges.
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From page 479... ...
In this report, the committee provides guidance on data sources for and strategies to collect data on the indicators that could be included in Medicare quality measurement and payment programs that the committee identified in its third report. Chapter 2 describes three general categories of data sources the committee considered -- existing and new sources of CMS data, data sources from providers, and alternative government data sources.
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From page 480... ...
health care. New England Journal of Medicine 372(10)
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