Center for Medicare and Medicaid Services (CMS) conducts and publishes an assessment of the quality and efficiency impact of the use of endorsed measures in CMS programs every three years as required by statute. The first report was published March 1, 2012 and the 2018 Impact Assessment Report is the third such report. The data-driven results of this Report support the use of measures implemented in CMS reporting programs to drive improvement in the quality of care provided to patients in facilities and across settings nationwide. This report is used by the measure developer community, patients and families, clinicians, providers, federal partners, and researchers.
The 2018 Impact Assessment Report demonstrates that performance on CMS measures contributed to better care and reduced expenditures, and identified critical areas of improvement across settings with respect to six CMS quality priorities: patient safety, person and family engagement, care coordination, effective treatment, healthy living, and affordable care.
Highlights include these main findings:
- Patient impacts estimated from improved national measure rates indicated approximately:
- 670,000 additional patients with controlled blood pressure (2006–2015).
- 510,000 fewer patients with poor diabetes control (2006–2015).
- 12,000 fewer deaths following hospitalization for a heart attack (2008–2015).
- 70,000 fewer unplanned readmissions (2011–2015).
- 840,000 fewer pressure ulcers among nursing home residents (2011–2015).
- 9 million more patients reporting a highly favorable experience with their hospital (2008–2015).
- Costs avoided were estimated for a subset of Key Indicators, data permitting. The highest were associated with increased medication adherence ($4.2 billion–$26.9 billion), reduced pressure ulcers ($2.8 billion–$20.0 billion), and fewer patients with poor control of diabetes ($6.5 billion–$10.4 billion).
- National performance trends are improving for 60% of the measures analyzed, including a majority of outcome measures, and are stable for about 31%.
- Overwhelmingly, hospitals (92%) and nursing homes (91%) surveyed reported they consider CMS measures clinically important. Likewise, 90% of hospitals and 83% of nursing homes agreed that performance on CMS quality measures reflects improvements in care. Respondents also described barriers to reporting, including burden; barriers to improving performance; and unintended consequences of CMS measures.