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Capitol Correspondence - 03.12.24

CMS Quality Measure Report Highlights Impact and Challenges Amidst COVID-19

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A recent report from the Centers for Medicare & Medicaid Services (CMS) delves into the analysis of quality measure results spanning from 2016 to 2021 across 26 quality and value-based incentive payment programs. The findings spotlight the positive impacts on millions of patients and substantial costs avoided through improvements in measure performance, particularly before the COVID-19 pandemic. However, challenges emerged in 2020 and 2021, with COVID-19 disrupting health systems and leading to a decline in the performance of a significant proportion of measures compared to baseline trends prior to the public health emergency.

The report aligns strongly with the CMS National Quality Strategy, placing a significant emphasis on health equity. It identifies persistent health disparities, particularly among racial/ethnic groups and dually eligible enrollees, across the majority of analyzed measures. In an effort to reduce administrative and regulatory burdens, CMS has strategically decreased the overall number of quality measures from 578 in 2016 to 492 in 2023.

The report, mandated by the Social Security Act, serves as a comprehensive triennial analysis of the quality and efficiency impact of endorsed measures. This fifth report in the series since 2012 captures a unique moment in history, comparing pre-COVID-19 measure scores with those from 2020 and 2021, offering a snapshot of the initial impact of the pandemic on health care quality and efficiency. As the story continues, subsequent impact assessments will incorporate more complete data, providing a nuanced understanding of the evolving landscape.