NEJM December 28, 2016
The United States is rapidly moving to a health care delivery system in which value-based payment models are the predominant way of reimbursing clinicians for care. Since caring for patients with social risk factors may cost more and make it harder to achieve high performance on quality metrics, there is long-standing concern about how these patients might fare under such systems and how the systems might affect providers who disproportionately provide care to socially at-risk populations.
In October 2014, Congress passed the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, which required the Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the Department of Health and Human Services to review the evidence linking social risk factors with performance...
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