• Working through the Measure Incubator®, NQF is facilitating multistakeholder feedback on food insecurity quality measures.

    The Opportunity

    Food insecurity is a social determinant of health (SDoH) that affects one in nine American households. Food insecurity and other SDoH have a significant impact on disparities in health, healthcare, and health outcomes. In particular, food insecurity contributes to diabetes, stroke, cancer, hypertension, asthma, chronic kidney disease, and other chronic conditions. Addressing and accounting for SDoH is critical for improving healthcare quality and achieving health equity. Yet, healthcare quality improvement efforts have largely excluded food insecurity and SDoH. Establishing performance measures that address food insecurity within the clinical setting is critical to improving health and health outcomes for individuals with food insecurity.

    About the Project

    As a first step, NQF convened a Measure Incubator® strategy session with a multistakeholder Expert Panel in June 2018. At this meeting, panelists considered strategies to overcome the impact of food insecurity on health outcomes, building on prior work convened by NQF. NQF engaged a broad stakeholder group in this project, including patient partners that work with the food-insecure populations, clinicians, payers, researchers, and measure developers. The Panel emphasized that food insecurity screening must be paired with appropriate clinical action and consideration of disparities-sensitive conditions to effect change and address SDoH, particularly food insecurity, within the context of the healthcare system.

    Building on the strategy session findings, Quality Insights is developing three measure concepts into fully-specified and tested electronic clinical quality measures (eCQMs) that examine food insecurity screening, appropriate clinical action (e.g., referral), and change in food insecurity status through the National Quality Forum (NQF) Measure Incubator®. Initial development and testing of the three electronic clinical quality measures (eCQMs) began in 2019.

    Public Feedback Opportunity

    NQF is soliciting public comments on the three food insecurity quality measures (PDF) listed above, including:

    • General comments on measures under development;
    • Input on critical components of the proposed measures, such as numerator, denominator criteria, stratification, risk-adjustment, accountability and performance improvement, usability and attribution; Measure-specific feedback, such as measure importance (see public comment page for more details); and,
    • Feedback on potential data availability and implementation barriers and proposed solutions.


    This Measure Incubator® project is supported by Humana – By addressing social determinants of health, Humana has committed to improving population health and giving back more Healthy Days to every community they serve.

    Contact Information

    For more information, contact the Quality Insights project team at tstump@qualityinsights.org and the NQF team at incubator@qualityforum.org.

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