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Conceptual Errors in the CMS Refusal to Make Socioeconomic Adjustments in Readmission and Other Quality Measures

Atkinson, Graham DPhil; Giovanis, Theodore MBA

Journal of Ambulatory Care Management: July/September 2014 - Volume 37 - Issue 3 - p 269–272
doi: 10.1097/JAC.0000000000000042
Original Articles

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.

JKTG Foundation, Washington, District of Columbia.

Correspondence: Graham Atkinson, DPhil, JKTG Foundation, 800 25th St NW, #1004, Washington, DC 20037 (

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins