In collaboration with Centers for Medicare & Medicaid Services, NQF will create a measurement framework to assess food insecurity and housing instability. Read more

Description

The Opportunity

Social determinants of health (SDOH) are critical factors that influence the health outcomes of individuals. Economic stability, in particular, has a profound impact on health and health care outcomes due to its direct relationship with basic human needs. Among the primary issues of economic stability are food insecurity and housing instability. Both concepts include varying forms of homelessness and hunger. Several interventions are effective in reducing housing instability and food insecurity. For example, a systematic review of the impact of food banks on food insecurity found that food banks have the potential to improve food security outcomes (e.g. quantity and quality of food eaten). Another review of interventions found that permanent housing support, assertive community treatment, and intensive case management services significantly improved housing stability outcomes (e.g. reductions in homelessness). However, health care organizations rarely assess risk or employ interventions to reduce food insecurity and housing instability. Measurement can quantify the degree of food insecurity and housing instability within a community. Similarly, performance can be measured to quantify the level to which health care providers are assessing risk and connecting patients to resources. Finally, measurement can be applied to determine the effectiveness of interventions to reduce housing instability and food insecurity. These measures can then be used for both quality improvement and accountability initiatives. A framework is needed to guide measure development and ensure a systematic approach.

About this Project

Objectives

In collaboration with Centers for Medicare & Medicaid Services, NQF will create a measurement framework to assess food insecurity and housing instability. A measurement framework is a conceptual model for organizing ideas about what is important to measure and how measurement should take place (e.g., whose performance should be measured, care settings where measurement is needed, when measurement should occur, which individuals should be included in measurement, etc.). The framework provides a structure for organizing currently available measures, areas where gaps in measurement exist, and prioritization for future measure development. To accomplish this task, NQF will:

  • Convene a multi-stakeholder group of SDOH experts with specific expertise in housing instability, food insecurity, and measurement;
  • Conduct a review of the evidence of effective interventions and conceptual frameworks for measuring outcomes related to food insecurity and housing instability;
  • Conduct environmental scan of performance measures that can be used to assess food insecurity and housing instability;
  • Key informant interviews with other experts in the field;
  • Document the expert panel’s recommendations in a final report.

NQF Process

To develop a measurement framework that captures all important areas to measure, NQF will convene an Expert Panel drawing on members of existing NQF standing committees including Health and Well-Being and Disparities Standing Committees and the SDOH Expert Panel. The panel will comprise experts in SDOH with specific expertise in housing stability and food insecurity. The group of 10-12 experts will embody a wide variety of stakeholders groups including but not limited to clinicians, researchers, health plans, health systems, and consumer advocates. The Expert Panel will provide guidance on the approach to each deliverable and ultimately provide recommendations for the development of the conceptual framework. In addition, through the direction of the expert panel NQF will draw on the expertise of key informants to inform the literature review and environmental scan.

Related NQF Work

Contact Information

For more information, contact the project team at 202-783-1300 or foodandhousing@qualityforum.org.

In collaboration with Centers for Medicare & Medicaid Services, NQF will create a measurement framework to assess food insecurity and housing instability. Read more

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