Risk Adjustment for Socioeconomic Status - story
Risk Adjustment for Socioeconomic Status NQF is at the forefront of a national discussion about whether healthcare performance measures should be adjusted for socioeconomic status (SES) and other demographic factors, such as income, education, and health literacy. The academic community has debated this issue for years, and in 2014, the U.S. Department of Health and Human Services provided funding that allowed NQF to advance the discussion toward a resolution. After an extensive examination of the issue led by an NQF-convened Expert Panel, NQF’s Board of Directors approved a change in its policy to allow for SES risk adjusting of appropriate performance measures during a two-year trial. The results of the trial, which began in April 2015, will guide NQF on whether to make this policy change permanent. Currently, the trial includes 32 measures (PDF) that span the areas of cost and resource use, all-cause admissions and readmissions, and cardiovascular care.
NQF standing committees that are conducting measure review or endorsement projects are also determining which measures should be included in the trial as well as identifying which SES factors measure developers should test in their empirical analyses for SES adjustment. Once measure developers have collected the needed data, the standing committee will evaluate it to determine how risk adjustment affects a measure. The standing committee will also assess for unintended consequences, such as a weakening of the network of providers serving disadvantaged populations.
More information on the trial, including upcoming meetings, is available on the SES Trial Period project page.
A key initial focus of NQF’s newly seated Disparities Standing Committee (DSC) will be to review how standing committees are implementing the revised NQF policy to risk adjust for SES and to evaluate the trial overall. Informed by this work, the DSC will develop a high-level roadmap to better measure disparities and consider how measurement can proactively reduce them.
SES Trial PeriodMeasures in the SES Trial (PDF)Disparities Projectraandses@qualityforum.orgLeading the National DialogueRisk adjustment for socioeconomic status#E4801C
