"We think that there is a large body of emerging evidence showing the sociodemographic factors can influence health outcomes," Feldpush says. "That includes these factors in risk-adjustment models where there is evidence to do so will really improve the science of performance measurements."
Practically speaking, Feldpush says bringing sociodemographic data such as income, race, and access to insurance will create "a more accurate picture of performance, which means that some institutions that are doing very well now may not do as well, and some institutions that are not doing as well now may do better. We think the overall effect is that it will improve accuracy and really shed light on the true performance for various hospitals."
Currently none of that is taken into account now. "For individual patients for example with readmissions measures, their medical history is taken into account and I guess some very common socio-economic demographics such as age and gender are used," Feldpush says. "But you don't get any sense as to the individual's income level or education level or anything related to the community in which they live."
Feldpush says she can't predict how safety net hospitals or any entire class of providers will be affected if CMS takes up the NQF recommendations. "We think it will really improve the clarity of the picture and you're certainly going to see a difference in performance across the field," she says.