Summary
As the USA's largest health insurer, the Centers for Medicare & Medicaid Services (CMS) has established quality standards, metrics, and programmes to improve healthcare not just for the 170 million individuals supported by its programmes, but for all Americans. The 2024 National Impact Assessment of CMS Quality Measures Report (Impact Assessment Report) assesses the quality and efficiency impact of measures endorsed by the consensus-based entity and used by CMS.
Content
The report findings suggest that improvements in measure performance are associated with patient impacts and costs avoided for select CMS healthcare quality priorities and programmes, particularly prior to the Covid-19 pandemic. During 2020 and 2021, a relatively large proportion of measures had worse than expected performance, including significant worsening of key patient safety metrics. Covid-19 created challenges for most health systems that limited capacity to sustain improvement for certain priorities and goals during a pandemic. CMS continued progress in increasing the proportion of outcome measures and reducing burden through use of fewer measures across the portfolio. Persistent health equity gaps for historically disadvantaged groups were identified for the vast majority of measures analysed, and perspectives from focus groups underscored the critical need to develop equity 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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