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 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.
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.
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