CHA News Article

Institute of Medicine Report Examines Socioeconomic Risk Adjustment

The Institute of Medicine (IOM), in preparation for providing analysis for congressionally mandated reports in 2016 and 2019, issued the first in a series of five reports that will explore whether socioeconomic status (SES) and other social risk factors could be accounted for in Medicare payment and quality programs. The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 requires the Secretary of Health and Human Services to issue a report to Congress by October 2016 that assesses the impact of SES on quality and resource use in Medicare, using measures such as poverty and rurality from existing Medicare data. It also requires a report to Congress by October 2019 on the impact of SES on quality and resource use in Medicare, using measures from other data sources.

The IOM’s first report presents a conceptual framework and describes the results of a literature search linking social risk factors, including socioeconomic position, to health-related measures of importance to Medicare payment and quality programs. In subsequent reports, the committee will address the question of whether a specific social factor could be incorporated into Medicare payment programs, the methods to do so and data needs to accomplish the task. The committee will include comprehensive project findings, conclusions and recommendations in its final report. The first report is available for download online.

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