Forum Session Announcement - Sociodemographic Risk Adjustment: Protecting the Safety Net?

Forum Session Announcement - Sociodemographic Risk Adjustment: Protecting the Safety Net? F O R U M S E S S I O N Sociodemographic Risk Adjustment: Protecting the Safety Net?SEPTEMBER 26, 2014 The growing desire by both Medicare and private insurers to pay for health care on the basis of “value” rather than volume has heightened attention to how performance on quality and outcomes of care are meas. [...] Critics argue that risk-adjusting measures for sociodemographic factors “codifies a soft bigotry of low expectations,”2 runs the risk of masking true disparities in patient outcomes, and lets provid- ers “off the hook” by allowing them to continue to do business as usual.3 They also assert that adjusting measures to reduce penalties for those serving more disadvantaged patients is the wrong way to. [...] In a memorandum accompanying the Panel’s first draft report, made available to the public for comment in March 2014, NQF staff re- ported that the Expert Panel had concluded that the “current policy is unintentionally weakening the network of providers that serve disadvantaged populations, which could end up worsening dispar- ities.”6 The report called for revising existing NQF policy to include s. [...] In its next draft, issued in July 2014, the Panel responded to public comments about the appropriateness of adjusting for sociodemo- graphic factors by: • requiring measure specifications for stratification to identify dis- parities if a performance measure is adjusted for sociodemographic status (SDS), • recommending a transition period during which a clinically ad- justed version of the performa. [...] The Board accepted the Committee’s recommendation to lift NQF’s restriction against sociodemographic adjustment during a “robust trial period” which will be used to “assess the impact and implica- tions of risk adjusting relevant quality measures for sociodemo- graphic factors” prior to any permanent change in policy.8 A new standing Disparities Committee will help with the trial period and its ev.