In Reply Mr Chen and colleagues suggest that risk adjustment goals would be better specified by comparing “clinicians’ performance if hypothetically given the same mix of patients” instead of “controlling for factors beyond the reach of clinicians or health systems.”1 However, both phrases would have similar meanings if “same mix” is interpreted as applying to “factors beyond the reach of clinicians and health systems,” an interpretation that follows from the purpose of risk adjustment.
Braithwaite RS. Risk Adjustment Methods in Quality Measurement—Reply. JAMA. 2018;320(15):1605. doi:10.1001/jama.2018.11519
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