The National Quality Forum conducted a two-year trial demonstrating the feasibility of incorporating social risk factors into healthcare performance measures.
Normally, NQF only allows measures to be adjusted for clinical factors present at the start of a patient's care. During the two-year trial period, the forum temporarily changed this policy to allow risk adjustment for social factors like education, income and language.
NQF examined 303 performance measures across 16 areas, including all those submitted for review from April 2015 to April 2017. Of the reviewed measures, 93 included some form of risk adjustment, 65 had a conceptual basis for risk adjustment and 17 were endorsed with social risk adjustment.
The trial found incorporating social risk factors in the performance measures was a feasible, although challenging process. NQF cited numerous obstacles to social risk adjustment, including obtaining enough data on social risk factors.
"Every stakeholder wants to see the quality of care for all Americans, especially the most vulnerable, improve while ensuring a level playing field for providers in value-based purchasing programs," NQF President and CEO Shantanu Agrawal, MD, said in an emailed press release. "The frequent use of NQF-endorsed measures for payment purposes underscores the importance of ensuring accurate comparisons of providers so that rewards or penalties are fairly assessed and based on true differences in performance."
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