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National Quality Forum Approves Trial Period to Review Sociodemographic Adjusted Accountability Measures

July 25, 2014— The National Quality Forum (NQF) Board of Directors July 23 approved the implementation of a trial period in which relevant quality measures would be risk adjusted to include sociodemographic factors. The results of this trial run will be used to determine whether the NQF should adopt a formal policy on sociodemographic adjustment.

Outcomes measures are typically adjusted to account for differences in patient health status and clinical factors (e.g., severity of illness and co-morbidities), but not sociodemographic status (e.g., income, race, English proficiency, and education).

The NQF Board’s decision to create a trial period follows the release of an NQF expert panel draft report in March [See Washington Highlights, March 21], which recommended that NQF change their policy to allow sociodemographic status factors to be included in the risk-adjustment methodology for certain accountability measures.

The Consensus Standards Approval Committee (CSAC), an NQF advisory committee that oversees the expert panels, chose to support a new recommendation that would establish a sociodemographic trial period, postponing an official change in NQF policy.

The NQF board voted to approve the CSAC’s recommendation, along with the creation of a standing Disparities Committee, an additional recommendation of the expert panel. The Disparities Committee would assist with the trial period and evaluation.  

The structure, duration, measure submission requirements, and evaluation objectives of the trial run have not yet been established. During the trial period, NQF stakeholders and staff will assess the implications and impact of including sociodemographic status factors in the risk adjustment for performance measures. 

The AAMC has advocated for certain measures, particularly those relating to readmissions and Medicare Spending per Beneficiary, to be adjusted for SES factors in order to improve the accuracy of performance results [See Washington Highlights, Feb. 28].


Scott Wetzel, M.P.P.
Lead, Quality Reporting
Telephone: 202-828-0495


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