Humana & National Quality Forum Say New Value-Based Payment Models Should Include Social Risks

As payers move toward population-based payment models, the National Qualify Forum (NQF) and Humana believe that the models should evaluate both social risk and clinical risk to acknowledge the interdependence of social, behavioral, and environmental factors on health outcomes. The payment models should provide incentives for addressing health-related social needs such as food access, environmental safety, and social support. Current risk-adjustment models assume that these factors exist in isolation; they include some factors while excluding others, and fail to capture …

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