Keywords: disparity, Medicare, random effects model, socioeconomic status
The National Quality Forum (NQF) recently recommended that quality measures used in accountability and payment applications be assessed to determine whether they should be adjusted for differences in patient socioeconomic status (SES) between providers. Both public and private payers are exploring the potential effects of adjusting for SES. This presentation will cover methodological considerations when risk-adjusting quality measures for SES. Topics that will be covered include why adjustment for within-provider SES differences is appropriate for quality measures and how within-provider differences differ from total and between-provider differences. These methodological issues are explored using data from the Medicare Part C and D Star Rating program.