Risk Adjustment for Quality Measures Is Neither Binary nor Mandatory

Holding health care organizations and clinicians accountable for health care quality has been championed by the Joint Commission, the Centers for Medicare & Medicaid Services (CMS), and health care payers for more than 15 years. More recently, quality assessment has increasingly emphasized outco...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2018-05, Vol.319 (20), p.2077-2078
Main Author: Braithwaite, R. Scott
Format: Article
Language:English
Subjects:
Clinical outcomes
Control methods
Government programs
Health care
Health services
Humans
Outcome Assessment (Health Care)
Quality assessment
Quality control
Quality Indicators, Health Care
Quality of care
Risk
Risk Adjustment - methods
Risk management
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Summary:Holding health care organizations and clinicians accountable for health care quality has been championed by the Joint Commission, the Centers for Medicare & Medicaid Services (CMS), and health care payers for more than 15 years. More recently, quality assessment has increasingly emphasized outcome measures rather than process measures, as outcomes are of greater interest to patients and payers. However, because outcomes are less directly controlled by clinicians and health systems than processes, this emphasis has magnified the importance of using robust risk adjustment methods to control for factors beyond the reach of clinicians or health systems.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2018.3368