The National Quality Forum (NQF) has released a draft report, A Roadmap to Reduce Health and Healthcare Disparities through Measurement. The report was developed by NQF Standing Committee on Disparities, and was funded by the Centers for Medicare and Medicaid Services Office of Minority Health. The report proposes four steps for reducing health and healthcare disparities through performance measurement:

  • Step 1: Prioritize disparities-sensitive measures
  • Step 2: Identify evidence-based interventions to reduce disparities
  • Step 3: Select and use health equity performance measures
  • Step 4: Incentivize the reduction of health disparities and achievement of health equity.

For Step 1, the Committee revised prior criteria for prioritizing disparities-sensitive measures:

  • Prevalence: how prevalent is the condition among populations with social risk factors? what is the impact of the condition on the health of populations with social risk factors?
  • Size of the disparity: how large is the gap in quality, access, and/or health outcome between the group with social risk factors and the group with the highest quality ratings for that measure?
  • Impact of the quality process: how strong is the evidence linking improvement in performance on the measure to improved outcomes in the population with social risk factors?
  • Ease and feasibility of improving the quality process (actionable): is the measure actionable among the population with social risk factors?

For Step 2, the report highlights the importance of identifying and implementing interventions at multiple levels: the patient and family level, provider level, organization level, community level, and policy level.

For Step 3, the report identified five domains for health equity performance measurement:

  • Collaborate and partner with other organizations or agencies that influence the health of individuals
  • Adopt and implement a culture of equity
  • Create structures that support a culture of equity
  • Ensure equitable access to healthcare
  • Ensure high-quality care within systems that continuously reduce disparities

For Step 4, the report identifies four strategies to incentivize the reduction of disparities:

  1. Implement health equity measures
  2. Incentivize health equity through payment reform
  3. Support organizations that disproportionately serve individuals with social risk factors
  4. Develop and implement demonstration projects with rigorous evaluation partnering with equity researchers

Comments are due on August 21, 2017 and may be submitted through the NQF website.


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