The trial was part of compromise that NQF brokered between providers—primarily hospitals—who say risk-adjustment is necessary for fairness, and others who say it could artificially raise the performance score of providers treating the most vulnerable patients and mask disparities.

New measures submitted to NQF for endorsement after April 15 of this year are being assessed by the relevant NQF standing committees to determine if risk adjustment is appropriate. Previously endorsed measures may also be reviewed, and some—related to readmissions, as well as cost and resource use—are currently in the trial. If adjustment is determined to be appropriate for a given measure, the NQF endorsed measure will include SES-adjusted, non-adjusted, and stratified versions of the measure.

NQF is committed to making the processes and outcomes of the trial period transparent to all stakeholders throughout the duration of the trial period. Based on the results of the trial, the NQF board of directors will decide whether the change in policy that lifts the prohibition regarding inclusion of SES factors in risk adjustment should be made permanent.