Developing Federal Policy Options for Social Risk Payment Adjustment

This goal of this project is to develop stakeholder-driven policy options for the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI) to use area-based indices of social risk to adjust clinical payments. The research team would identify mechanisms for how to adjust payments in Medicare and Medicaid, considerations for the amount of those payment adjustments, and options for ensuring enhanced payments are used to identify and address social needs of patients. To achieve this, American Board of Family Medicine plans to 1) hold two workshops (one focused on Medicare and one on Medicaid) with policymakers, payers, and other experts to develop and refine policy options; 2) reengage CMS and CMMI to share the policy options and identify next steps for implementation; and 3) generate broad support for the recommendations among affected stakeholders through targeted outreach, public presentations, and peer-reviewed publications.