HHS Issues Report on Accounting for Social Risk Factors in VBP Programs

July 20, 2020

The Assistant Secretary for Planning and Evaluation (ASPE), the principal advisor to the Secretary of the US Department of Health and Human Services (HHS), recently released several reports detailing strategies and policy recommendations to account for social risk in Medicare’s value-based purchasing (VBP) programs. The reports were required by the 2014 Improving Medicare Post-Acute Transformation (IMPACT) Act. ASPE recommendations to HHS and the Centers for Medicare & Medicaid Services include developing a comprehensive risk-adjustment framework that accounts for social risk factors and using VBP incentive payments to support safety net providers and partners who serve socially at-risk beneficiaries.

ASPE’s recommendations align with the social determinants of health (SDH) strategies of many GNYHA member hospitals. Included in ASPE’s recommendations are the development of social risk data collection and interoperability standards, the inclusion of health equity measures in quality and VBP programs, and building links with community-based organizations (CBOs). Additionally, the recommendations call for increased infrastructure and community resource options to address beneficiaries’ health-related social needs outside of clinical settings.

ASPE’s reports were informed partly by a request for information on provider and health plan approaches to improving care for Medicare beneficiaries with social risk factors to which GNYHA responded. GNYHA is also engaged in various efforts that align with the report’s strategy areas. GNYHA participates in the Gravity Project, a public collaborative focused on developing a recommended framework and interoperability standards for specific social needs. GNYHA’s SDH workgroup convenes members to discuss data collection processes and CBO partnerships. GNYHA is also working on a project that seeks to inform contractual relationships between health care organizations and CBOs and will share learnings at the project’s conclusion. GNYHA will continue supporting members in their SDH initiatives and following related State and Federal policies.