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NQF Approves Trial of Sociodemographic Risk Adjustment

The National Quality Forum (NQF) board of directors voted July 23 to adopt the recommendation of the NQF Consensus Standards Approval Committee (CSAC) to, on a trial basis, assess the impact and implications of risk adjusting certain quality measures.

During the trial period, clinically and sociodemographically adjusted measures may be endorsed by the NQF, although the details of the process are not yet clear. NQF plans to develop additional details, including the duration of the trial, the measure submission requirements, and the evaluation objectives necessary to inform future NQF policy.

CSAC issued its recommendation after reviewing an NQF expert panel’s report on Risk Adjustment for Socioeconomic Status or Other Sociodemographic Factors. The expert panel had recommended stronger actions than the CSAC ultimately approved. Among other findings, the expert panel recommended that sociodemographic factors should be included in risk adjustment scores when there is a logical rationale that the factors and health outcomes might be linked.

America’s Essential Hospitals is disappointed that the CSAC recommendation for a trial period did not go as far as the expert panel’s recommendations to risk adjust quality measures. A growing body of literature shows that sociodemographic factors such as income, education, race, ethnicity, and primary language can influence patient outcomes. America’s Essential Hospitals continues to engage with NQF and other stakeholders on this issue.

Contact Beth Feldpush, senior vice president of policy and advocacy, at or 202.585.0111 with questions.


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