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ACP does not support QPP measure 286: “Dementia: Counseling Regarding Safety Concerns." Counseling of patients and caregivers regarding safety issues is good clinical practice and clinicians can implement interventions that are likely to improve safety outcomes (e.g., PT/OT home assessment, Visiting Nurse Services), and the measure is appropriately specified. Also, the numerator specifications detail an exhaustive intervention list, allowing clinicians to assess for safety concerns that are particularly relevant to a specific patient’s venue. However, there is no evidence to support the impact of this intervention on clinical outcomes, the level or intensity of counseling required to change behavior, or the interval at which this intervention should be performed. Finally, this measure could pose burden on clinicians who care for dementia patients and there is a lack of high-quality evidence to support the intervention as an accountability measure.