Journal
HEALTH AFFAIRS
Volume 40, Issue 4, Pages 637-644Publisher
PROJECT HOPE
DOI: 10.1377/hlthaff.2020.01764
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The practice of adjusting quality measures using social risk factors remains controversial, but can be appropriate and necessary in specific circumstances. By making social risk adjustment the default option when valid empirical arguments exist, inequities within the healthcare system can be avoided.
Risk adjustment of quality measures using clinical risk factors is widely accepted; risk adjustment using social risk factors remains controversial. We argue here that social risk adjustment is appropriate and necessary in defined circumstances and that social risk adjustment should be the default option when there are valid empirical arguments for and against adjustment for a given measure. Social risk adjustment is an important way to avoid exacerbating inequity in the health care system.
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