AAHKS Risk Adjustment Initiative: Why Is It Important?

Risk adjustment is critical when any comparison of hospital performance or surgeon performance on patient outcomes is being measured. The purpose of risk adjustment is to level the playing field in making comparisons of outcome either against the benchmark or across individual providers, hospitals, or provider groups. The consequences of not leveling the playing field may lead to the inappropriate inference of high quality, that is outcomes are better not because of better quality but because the patients are healthy. Additional consequence of not leveling the playing field is the inappropriate inference of low quality, that is outcomes are worse not because of lower quality but because patients are less healthy at the onset. Therefore, it is critically important that risk adjustment is done properly so that access for the patients with the most severe problems will be maintained. Surgeons and hospitals should not be discouraged from providing care for these individuals for fear of publicly reporting outcomes that are not properly risk adjusted. To that end, American Association of Hip and Knee Surgeons created a Risk Adjustment Task Force to collaborate with Center for Medicare and Medicaid Services in creating a more robust risk adjustment model to take into account clinical factors and severity of orthopedic disease.