A central tenant of the move to value-based payment in health care is that quality can be measured and high quality providers should be rewarded for their excellence. But efforts to define and measure quality of care can run into challenges.

It's considered benign to take certain types of risk factors, such as disease severity, into account when measuring quality of care. But accounting for social risk factors, like poverty or housing instability, is a lot more controversial.

It's also the subject of today's A Health Podyssey.

In an April 2021 paper as part of Health Affairs' Policy Insights series, David Nerenz, director emeritus of the Center for Health Policy and Health Services Research at the Henry Ford Health System, and colleagues reviewed the arguments surrounding social risk factors and their inclusion in quality metrics. They concluded that "social risk adjustment should be the default option," and that is can be an important tool for promoting health equity.

Listen to Health Affairs Editor-in-Chief Alan Weil interview David Nerenz on social risk factors, his research, and what it means for hospitals to take responsibility for social determinants of health.

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