Risk Adjustment Guidance Final Environmental Scan 

Risk adjusting measures to account for differences in patient health status and clinical factors (e.g., comorbidities, severity of illness) that are present at the start of care has been widely accepted and implemented. Even so, providers are in need of comprehensive, reliable, and timely information to make quality care decisions that result in improved outcomes for patients. To provide stakeholders with information that can be used to compare patient outcomes in an unbiased manner, NQF conducted an environmental scan to identify current uses of functional and social risk factors in quality measurement, including currently available guidance on risk adjustment modeling. The environmental scan was completed via a three-pronged approach that included a review of literature, NQF-endorsed measures, and quality improvement programs. NQF also drew on insights from an NQF-convened Technical Expert Panel and comments received from the public. The results of the environmental scan will inform the next phase of this work, which is the development of a Technical Guidance report that will include the steps, good practices, and minimum standards for developing risk adjustment models for quality performance measures that account for social and/or functional risk factors.