AAPI Nexus: Policy, Practice and Community

Adjustments for the underlying differences in risks among patients in payment approaches has been widely used and accepted; yet current risk adjustment approaches are limited because they do not account for the various social determinants of health (SDH) that can also influence health outcomes. This can have implications for providers serving disadvantaged populations. This article discusses why the inclusion of SDH in the formulas for risk adjustment is important for federally qualified health centers (FQHCs) under the Patient Protection and Affordable Care Act (ACA) and recommends ways in which FQHCs can be leaders in informing payment reform policies.