July 12, 2023
Inequities and SDOH | Tea Leaves
  • Last year, the Centers for Medicare and Medicaid Services (CMS) started using the area deprivation index (ADI) to adjust payment rates and quality incentives in some models to encourage participating providers to offer care to disadvantaged populations, but providers participating in alternate payment models fear the tool may inadvertently divert resources from some communities that need them. An analysis by Sutter Health and Mount Sinai Health System found that factors incorporated into the ADI, such as average home prices, may not accurately capture health disparities in densely populated urban areas, leading to underestimation of social vulnerability in some communities. The study also found instances in which the Medicare Shared Savings Program ranked low-income areas in New York City’s Bronx borough with lower life expectancies, similar to communities in Manhattan’s high-income Upper East Side with higher life expectancies, masking significant inequities. The discrepancy could result in CMS distributing additional resources to wealthier rural neighborhoods instead of lower-income urban areas. (Article here)