Accounting for Social Risk Factors in Medicare Payment (2017)
Chapter: Appendix C: Criteria, Factors, and Methods
C
Criteria, Factors, and Methods
Appendix C reproduces in its entirety the third report from the Committee on Accounting for Socioeconomic Status in Medicare Payment Programs. The committee made no substantive content changes. This report was originally released on July 13, 2016, as:
National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for social risk factors in Medicare payment: Criteria, factors, and methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
CONTENTS
Criteria for Selecting Social Risk Factors
Applying Criteria to Social Risk Factors and Health Literacy
Methods to Account for Social Risk Factors in Value-Based Payment Programs
Rationale for Accounting for Social Risk Factors in Quality Measurement and Payment
Criteria for Selecting Social Risk Factors
Guidance Regarding the Process for Using Selection Criteria
C3 APPLYING SELECTION CRITERIA TO SOCIAL RISK FACTORS AND HEALTH LITERACY
Race, Ethnicity, and Cultural Context
C4 METHODS TO ACCOUNT FOR SOCIAL RISK FACTORS IN MEDICARE VALUE-BASED PAYMENT
Incentive Design in Medicare Payment Programs
Potential Harms of the Status Quo Compared to Accounting for Social Risk Factors
Methods to Account for Social Risk Factors in Value-Based Payment Programs
Applying Methods to Account for Social Risk Factors
Monitoring Methods to Account for Social Risk Factors
CA CRITERIA FOR SELECTING RISK FACTORS REVIEWED BY THE COMMITTEE
CAHPS Case-Mix Adjustment Criteria
HHS-HCC Risk Adjustment Model Criteria
National Quality Forum Criteria Guidelines for Selecting Risk Factors for Adjustment
This page intentionally left blank.
