Health Payer Intelligence April 15, 2021
Hannah Nelson

To ensure safety-net hospitals are not penalized under value-based payment programs, researchers contend that reimbursement should be contingent upon social risk factors.

Adjusting quality measures for social risk factors can promote health equity, according to expert guidance published in Health Affairs.

As value-based payment programs expand, there is growing concern that reimbursement models could penalize providers who serve the most vulnerable populations is growing.

The experts explained that while health outcome measures reflect quality of care, they are also contingent upon factors such as personal behavior and community resources. Therefore, they argue, health outcome measures should be adjusted for these non-quality related factors when appropriate.

For instance, providers serving socially vulnerable patients might yield lower-quality care scores compared to other...

Topics: Healthcare System, Patient / Consumer, Payment Models, Provider, SDOH, Value Based
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