Social Risk Adjustment of Quality Measures for Diabetes and Cardiovascular Disease in a Commercially Insured US Population

Key Points Question Is social risk associated with physician group performance on diabetes and cardiovascular disease quality measures? Findings In this cross-sectional study of more than 1.6 million enrollees from a large US health insurance plan, adjusting for social risk factors reduced physician group–level variance in performance scores and reordered rankings, particularly for disease control measures for diabetes and use-based outcome measures for both diabetes and cardiovascular disease. Process measure performance did not change significantly following adjustment for social risk factors. Meaning Social risk adjustment can affect performance scores for disease control and use-based outcome measures and thus should be considered as a way to mitigate potential unintended consequences of pay-for-performance programs.