Accounting for Social Risk Factors in Medicare Payment (2017) / Chapter Skim
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Appendix E: Prior Conclusions and Recommendations
Appendix E: Prior Conclusions and Recommendations
Pages 535-540
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From page 535... ...
, had no conclusions or recommendations, only findings. REPORT 2: SYSTEMS PRACTICES FOR THE CARE OF SOCIALLY AT-RISK POPULATIONS1 The committee concluded that six community-informed and patient centered systems practices show promise for improving care for socially at-risk populations: • Commitment to health equity: Value and promote health equity and hold yourself accountable.
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From page 536... ...
Conclusion 2: There are measurable social risk factors that could be accounted for in Medicare value based payment programs in the short term. Indicators include • Income, education, and dual eligibility; • Race, ethnicity, language, and nativity; • Marital/partnership status and living alone; and • Neighborhood deprivation, urbanicity, and housing.
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From page 537... ...
However, it is also important to minimize potential harms to these patients and to monitor the effect of any specific approach to account ing for social risk factors to ensure the absence of any unanticipated adverse effects on health disparities. Conclusion 5: Characteristics of a public reporting and payment sys tem that could accomplish the goals of reducing disparities in access, quality, and outcomes; quality improvement and efficient care delivery for all patients; fair and accurate public reporting; and compensating providers fairly include • Transparency and accountability for overall performance and per formance with respect to socially at-risk members of the population; • Accurate performance measurement -- with high reliability and without bias (systematic error)
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From page 538... ...
Recommendation 2: The committee recommends that the Centers for Medicare & Medicaid Services use existing data on dual eligibility, nativity, and urbanicity/rurality in Medicare performance measurement and payment. Recommendation 3: Data for individual measures of race and ethnicity, language, and marital/partnership status and for area-level measures of income, education, and neighborhood deprivation are currently avail able and the committee recommends that the Centers for Medicare & Medicaid Services (CMS)
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From page 539... ...
The committee recommends that CMS research ways to accurately collect housing data, whether at an individual level or an area level. Recommendation 6: The committee recommends that research be con ducted on the effect of acculturation, sexual orientation and gender identity, and environmental measures of residential and community context on health care outcomes of Medicare beneficiaries and on methods to accurately collect relevant data in the Medicare population.
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2016a. Accounting for social risk factors in Medicare payment: Identifying social risk factors.
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