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The Latest Research, Commentary, And News From Health Affairs

Thursday, April 22, 2021

Dear John,

**** Should the quality metrics used to judge providers' performance
take into account patients' social risk factors? Researcher David
Nerenz and coauthors assessed this debate and offered recommendations
for policy makers.

A Key To Promoting Health Equity When Measuring Care Quality

Providers are increasingly subject to payment policies based on their
performance, and there is consensus that we should consider clinical
factors, such as disease severity, when measuring the quality of a
provider's care. But adjusting for social risk factors, such as
poverty, remains controversial.

In an April 2021 paper as part of our Policy Insight series
,
David Nerenz and coauthors reviewed the arguments on both sides of this
debate and posed five questions that policy makers should consider when
making a determination for a particular quality measure. The authors
concluded that "social risk adjustment should be the default option,"
and that it can be an important tool for promoting health equity.

Nerenz will join Alan Weil on next week's A Health Podyssey

to discuss this paper.

Nerenz and colleagues also examined social risk adjustment in a
September 2020 Health Affairs Blog post
.
The authors discussed the distinction between health care quality and
outcomes and how differences in patient income can affect providers'
quality ratings in value-based payment systems.

For additional content on access to care, the Affordable Care Act,
health care spending, and more, read the April 2021 issue
.

Today on Health Affairs Blog, Katie Keith provides the latest on 2021
Affordable Care Act Marketplace enrollment, navigator funding, and more
.
In a new GrantWatch post, David Lakey and coauthors discuss several
Texas organizations working to integrate health care with the social
services sector

and highlight recommendations for better integration from a recent
report.  

Also on the blog, Erin J. Stringfellow and coauthors argue that
buprenorphine is an effective medication for opioid use disorder, but it
is vastly underutilized-many say because of the onerous X-waiver
requirement for clinicians
.
Finally, John Toussaint and coauthors argue that Better Care
Teams-multidisciplinary teams of providers that accept responsibility
for the cost and quality of care for a given population-must be
supported with value-based payment and transparent outcomes reporting
.

On Earth Day, we are revisiting our December 2020 theme issue, Climate &
Health . Papers in the
issue covered topics including the health sector's contribution to
carbon emissions and other forms of pollution, how communities are
affected by and adapting to the changing climate, and policies to
protect against further damage.

If you find our free COVID-19 research, blog posts, and podcasts useful,
please consider supporting our work
.

Your Daily Digest

Adjusting Quality Measures For Social Risk Factors Can Promote Equity In
Health Care

David R. Nerenz, J. Matthew Austin, Daniel Deutscher, Karen E. Joynt
Maddox, Eugene J. Nuccio, Christie Teigland, Eric Weinhandl, and Laurent
G. Glance

To Design Equitable Value-Based Payment Systems, We Must Adjust For
Social Risk

Philip M. Alberti, Christie Teigland, and David R. Nerenz

Marketplace Enrollment Tops 12 Million For 2021; Largest-Ever Funding
For Navigators

Katie Keith

Finding Effective Ways To Address Social Determinants Of Health

David Lakey, Elena Marks, and Eileen Nehme

Removing The X-Waiver Is One Small Step Toward Increasing Treatment Of
Opioid Use Disorder, But Great Leaps Are Needed

Erin J. Stringfellow, Keith Humphreys, and Mohammad S. Jalali

Better Care Teams: A Key Element Of Better Care Plans

John Toussaint, Stephen M. Shortell, and Peter A. Wadsworth

December 2020 Issue | Climate & Health

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