NASEM issues final report on accounting for social risk factors in Medicare payment

The National Academies of Sciences, Engineering, and Medicine today released the fifth and final report in a series examining social risk factors that affect the health outcomes of Medicare beneficiaries and how to account for these factors in Medicare value-based payment programs. The final report puts the series in context and offers additional thoughts about how to best consider the various methods for accounting for social risk factors. The committee supports four goals of accounting for social risk factors in Medicare payment programs: reducing disparities in access, quality and outcomes; improving quality and efficient care delivery for all patients; fair and accurate reporting; and compensating health plans and providers fairly. “These goals would best be achieved through payment based on performance measure scores adjusted for social risk factors (or adjusting payment directly for these risk factors) when combined with public reporting stratified by patient characteristics within reporting units,” the report concludes. Stratification, performance measure risk adjustment and payment adjustment are among the strategies to account for the impact of social risk factors in Medicare programs proposed by the Department of Health and Human Services last month.