According to a recent draft report released by the National Quality Forum, physicians serving financially disadvantaged patients may be at a disproportionately greater risk of receiving lower ratings, due to the fact that current policy allows for adjustment based on clinical factors but not sociodemographic factors, which have been shown to influence a variety of patient outcomes and some processes.  The NQF generally recommends revision of the NQF criteria related to risk adjustment to include sociodemographic factors as appropriate, but notes that this is not an absolute (i.e., neither an indication that all performance measures should always be adjusted for sociodemographic factors nor that they should never be adjusted for such factors).  The NQF received more than 650 comments on the draft report and expects to issue a final report in July 2014.