Health Care Quality Took a Big Hit During COVID, Medicare Report Finds

Axios | By Maya Goldman
 
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."