Feb 29, 2024 - Health

Health care quality took a big hit during COVID, Medicare report finds

Illustrated collage of a target with darts missing the mark.

Illustration: Eniola Odetunde/Axios

Progress on many key health care quality measures was reversed during the first two years of the pandemic, according to a new comprehensive federal review.

Why it matters: The report identified a "significant worsening" of patient safety measures and "persistent" health equity gaps for historically disadvantaged patients as COVID-19 overwhelmed the health care system.

Context: The federal government asks providers to report on a wide set of several hundred measures meant to assess health care quality.

  • Before the pandemic, from 2016 to 2019, providers' performance on more than half of quality metrics improved, the Centers for Medicare and Medicaid Services said.
  • CMS relaxed reporting requirements when the pandemic hit, but the agency said it continued to collect enough data to compare performance with long-term trends.

Zoom in: Performance on 38% of measures came in worse than expected in 2020, and 47% worse in 2021, CMS said.

  • About half of safety measures came in worse than expected in those two years.
  • In the starkest example, a measure of central line-associated bloodstream infections was 94% worse than expected in 2021.

Quality scores decreased more significantly for minority populations on some measures.

  • For instance, osteoporosis management for Black Medicare Advantage enrollees was 22.4 percentage points worse in 2021, while it fell 14.4 percentage points for white enrollees.

The bottom line: CMS said the data and feedback from focus groups show the need to develop measures that "address bias in care delivery and deficits in cultural competency, unmet health-related social needs, access, and health literacy."

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