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Socially ‘At Risk’ Beneficiaries and Quality Outcome Results

Posted on Tuesday, June 6, 2017 2:50 PM

For home health agencies who care for socially “at risk” communities, their outcome results and value based purchasing total performance scores can be impacted. According to Wikipedia, “The social determinants of health (SDOH) are the economic and social conditions and their distribution among the population that influence individual and group differences in health status.”  

Since patients' health begins in their homes and communities, patients without access or resources to health prevention, healthy lifestyles and healthy practices can struggle more to maintain or improve their health. According to Lisa Remington in her recent article, ‘The Great Debate: Addressing Social Risk Factors In Valued-Based Models’, outcome results, process measures and patient experience indicators are often lower for beneficiaries with social risk factors.

The recent buzz in the industry relates to addressing some of these social determinants by adding them to risk adjustment indicators. The goal would be to level the playing field amongst health care providers by making outcome scoring more equitable across populations.

Those with opposing views in the industry are concerned that it may cause health care providers to have two sets of care standards. Given the mission of most home health providers is to serve their communities and all populations, it is unlikely that this would occur.  

As home health providers try to stay solvent in a decreasing reimbursement environment, there is concern that health care providers will have to make difficult choices in the future related to caring for “at risk” populations if there is not a way to level the playing field.

To read the entire article, please click here.

Written by Sue Payne, Corridor’s Vice President of Clinical Services & Innovation.

About Corridor

Corridor is a trusted home health and hospice consulting partner to agencies both large and small. We provide the most up-to-date comprehensive homecare industry educational resources and consulting available.

We specialize in delivering better revenue cycle management solutions, coding and documentation review services, regulatory compliance, and healthcare consulting.

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