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Dr Shantanu Agrawal: Incorporating Social Risk Factors Into Performance Measures

Over 2 years, the National Quality Forum (NQF) studied how to best incorporate social risk factors into healthcare measurements and identified the biggest challenges, said Shantanu Agrawal, MD, MPhil, CEO and president of NQF.

Transcript (slightly modified)

What has the National Quality Forum found regarding how to incorporate social risk factors into healthcare performance measures?

We conducted, initially, a trial for 2 years looking at just that question of how to include social risk factors in measurement. We really challenged clinicians and measure developers when they felt there was a reasonable basis for including social risk factors to actually find the data and include those in the risk models to see what kind of statistical impact the social risk factors had on the risk models themselves.

I think what it showed is that, number 1, this is a really challenging area, and more work clearly needs to be done, but 2, we did actually identify, collectively, a number of measures that could be endorsed with social risk factor adjustment built in. Really it was a very worthwhile exercise, scientifically, because oftentimes we actually did get there. Third, and I think the biggest challenge, is that the trial made clear that there are not a lot of great data sources for social risk factor adjustment—data sources that you can rely on to tell you on a patient level or on a population level what social risks factors are, what their prevalence is in various populations. Then, to really test that against the risk adjustment models for measurement.

So, as we look forward, we conducted this initial trial for 2 years, we are really looking to continue our work for the next 3 years at least to see if we can help surface better data sources, help bring more consistency to how clinicians and measure developers are thinking about this in the context of measurement, and hopefully continue to drive progress.    

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