Expert panel report suggests criteria, methods to account for social risk factors in Medicare

A new report from the National Academies of Sciences, Engineering, and Medicine suggests criteria and methods that could be used to account for social risk factors in Medicare value-based purchasing programs. “The poorer average performance among providers disproportionately serving socially at-risk populations combined with the fact that they have fewer resources has raised concerns that Medicare’s VBP programs may potentially increase disparities,” the authors said. The report is the third in a series of five by a National Academies committee sponsored by the Department of Health and Human Services to identify criteria for selecting social risk factors, specific risk factors Medicare could use, and methods of accounting for those risk factors in Medicare quality measurement and payment. “Accounting for social risk factors in Medicare payments is not intended to obscure disparities that exist, but rather bring disparities to light,” said Donald Steinwachs, committee chair and professor at Johns Hopkins Bloomberg School of Public Health in Baltimore. “Payment systems should include sufficient incentives for quality improvement for both socially at-risk populations and to patients overall.”