title: Conceptual errors in the CMS refusal to make socioeconomic adjustments in readmission and other quality measures.
abstract: The Centers for Medicaid & Medicare Services has made a policy decision that socioeconomic factors should not be adjusted for in its various quality measures and point both to arguments made by the National Quality Forum and to analysis of the distributions of quality results to support this view. We present counterarguments to this viewpoint and use the results reported by the Centers for Medicaid & Medicare Services to support its position to demonstrate that adjustments are necessary. We further argue that the incentives for providers to improve performance would not be weakened by including socioeconomic factor adjustments.
authors.affiliation: JKTG Foundation, Washington, District of Columbia.
authors.forename: Graham
authors.initials: G
authors.lastname: Atkinson
authors.forename: Theodore
authors.initials: T
authors.lastname: Giovanis
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S. / Q000191:economics / Q000592:standards*; D004469:Economics, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008484:Medicaid / Q000191:economics / Q000592:standards*; D010359:Patient Readmission / Q000191:economics / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000191:economics / Q000592:standards*; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D012923:Social Class; D014481:United States