Institute of Medicine: Accounting for Social Risk Factors in Medicare Payment – Identifying Social Risk Factors

The Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services has asked the Institute of Medicine (IOM) of the National Academies of Sciences, Engineering, and Medicine to convene a committee to identify social risk factors that affect the health outcomes of Medicare beneficiaries, and to recommend methods to account for these factors in Medicare payment programs. The committee’s work will be conducted in phases and will produce five consensus reports.

In its first report, the IOM committee presents a conceptual framework and describes the results of a literature search linking social risk factors to health-related measures of importance to Medicare payment and quality programs.  The committee has identified the following social risk factors:

  • Socioeconomic position
  • Race, ethnicity, & cultural context
  • Gender
  • Social relationships
  • Residential & community context
  • Health literacy

In subsequent reports, the committee will specify criteria that could be used in determining which social factors should be accounted for in Medicare quality measurement and payment programs; identify methods that could be used in the application of these social factors to quality measurement and/or payment methodologies; and recommend existing or new sources of data and/or strategies for data collection.

The IOM also has published a brief summarizing this first report.

This entry was posted in Health Care Reform, Health Care Reform: Payment Reform, Health Care Reform: Quality Improvement, Health Status Disparities, Social Determinants of Health. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s