Risk Adjustment, Equity, Movement. Jumping in the Deep End

Can grasping risk adjustment contribute to a profound understanding of health inequities and motivate action to improve? Whaaattt are you talking about, you ask? As I write this episode, I’m preparing to join an NQF (National Quality Forum) Risk Adjustment Special Populations focus group. Understanding health disparities through measurement and experience and then acting on that information to improve equity ranks high on my list of advocacy priorities. I’m holding my nose, diving in, not at all sure I can swim. Granted, I don’t think NQF is asking this question. Rather they’re asking what we think about using a statistical process, risk adjustment, to compare the quality of hospitals and doctors more fairly. But like any good politician, I don’t want to answer the question asked of me.

Knowing enough to be dangerous

Let me start by saying that I am not an expert in disparities, equity, or health outcome measurement. After all, I am a two-legged, cisgender, old white man of privilege with access to the best healthcare in the world. I know enough to be curious and ask questions. I have been immersed in health measurement for my whole career. I have served on technical expert panels about healthcare outcomes and measurement for CMS (Center for Medicare and Medicaid Services), the National Academy of…