CMS: COVID-19 Erased Quality Measure Improvements

February 29th, 2024

By Jill Drachenberg, Editor, Relias Media

Many gains hospitals made on quality improvement measures were erased during the first two years of the COVID-19 public health emergency (PHE) — and, in fact, were worsened, according to the 2024 Impact Assessment Report from the Centers for Medicare and Medicaid Services (CMS).

Thirty-eight percent of measures were “worse than expected” in 2020 — a number that surged to 47% in 2021. Gains made in improving hospital-acquired infections were all but wiped out: Central line-associated bloodstream infections were 94% worse than expected in 2021, methicillin-resistant Staphylococcus aureus infections were 55% worse, and catheter-associated urinary tract infections were 34% worse. Racial and ethnic minority groups fared worse than white patients in most of these measures. Control of chronic conditions, including blood pressure and diabetes, also suffered. Breast and colorectal cancer screenings were 2.8 to 7.4 percentage points worse and 7 to 8.3 percentage points worse, respectively.

But not all was doom and gloom. Preventable readmissions improved by 0.5 to 2.7 percentage points in 2021. Hospitalizations of patients in home health and nursing homes improved by 0.7 to 1.5 percentage points.

It is important to note that the report “captures a unique moment in history,” CMS said. “Facing a surge of critically ill patients, the healthcare system had to react quickly to address constrained resources and the challenges of the pandemic,” they explained. “As CMS evaluates the policy changes issued throughout the COVID-19 PHE, best practices are being identified to prepare for future public health emergencies. Despite improving or stable trends across most healthcare quality priorities preceding the COVID-19 PHE (2016–2019), subsequent worsening of key metrics necessitates strategic actions to return to prepandemic levels and improve the resilience of the healthcare system. … Uncertainty remains about the lasting effects of the pandemic and the resilience of the health care system.”