New Report Reveals Performance on Health Care Quality Measures Declined in 2020

Analysis sheds light on key strategies needed to address COVID-19 impact on preventive and chronic care.

Minneapolis, MN (August 5, 2021) – A new report from MN Community Measurement (MNCM) documents how the COVID-19 pandemic has impacted the quality of care for other health conditions in 2020. The report is believed to be the first comprehensive source of information available to show how key metrics of health care quality and outcomes changed in 2020 compared to 2019. A series of issue briefs accompanying the summary report provides a deeper analysis of individual quality measures, including changes in the number of patients and outcomes by demographic characteristics such as age, race/ethnicity, geography, and socioeconomic characteristics in the communities where patients live.

Performance on key measures for chronic disease management and preventive care declined statewide in 2020. In addition, the number of patients included in most quality measures declined, which was likely a result of pandemic-related barriers affecting both patients and health care providers. For example, many patients chose to defer care due to safety concerns or barriers to accessing care via telehealth; on the provider side, factors like staff furloughs and reduced capacity during portions of the year contributed to the reduced availability of some services.

“We were not surprised to see declines in performance on quality measures and declines in the number of patients who received care in 2020,” said Julie Sonier, president and CEO of MNCM. “Nonetheless, the results are concerning because in many cases this means that health care providers are missing information that is normally used to manage patients’ health conditions to get the best long-term outcomes. As the health care system returns to more normal operations, concerted efforts will be needed to close these gaps.”

Key Findings

The report highlights three key findings from the analysis:

• There were large declines in the number of children included in quality measures for asthma and adolescent mental health screenings. Among those who did receive care and thus are included in the quality measures, results were more stable between 2019 and 2020 than they were for adults.
• The share of adults who were up to date on colon cancer screenings declined, as did the shares of adults whose diabetes, vascular disease, or asthma were optimally controlled. In many cases, declines in these quality measures were driven by the lack of lab tests, blood pressure readings, and patient questionnaires that are typically part of a health care visit.
• Monitoring of patients who have been diagnosed with depression is an issue that warrants particular focus, especially because of the COVID-19 pandemic’s impact on mental health. For both adults and adolescents previously diagnosed with depression, the data showed a substantial decline in the percentage who had their condition reassessed during a subsequent visit. While it is likely that difficulties in collecting this information for telehealth visits were a contributing factor, this issue calls for continued attention to ensure that expectations for care quality and patient outcomes are similar for care delivered via telehealth compared to in-person visits.

“More than half of Minnesota adults have a chronic condition that could put them at greater risk for severe illness and hospitalization from COVID-19,” said Minnesota Department of Health Assistant Commissioner Mary Manning. “The consequences of delayed care and undiagnosed chronic conditions may result in increased deaths and disability in the coming years. We need to track new forms of care that emerged during the pandemic, like telehealth, and their effectiveness in delivering high-quality care. Removing barriers to care and working with local partners to reach communities already experiencing health disparities are crucial to limiting further consequences of the COVID-19 pandemic.”

The scope of the data used in this analysis includes all patients that meet eligibility criteria for inclusion in a measure and nearly all health care providers in Minnesota. The data collected also includes information on patients’ race, ethnicity, language, and country of origin to better understand health disparities and to support the development of initiatives to improve health equity.

MN Community Measurement is a nonprofit organization dedicated to empowering health care decision-makers with meaningful data to drive improvement. A trusted source of health care data since 2005, MNCM works with doctors, hospitals, clinics, insurance companies, and state agencies to collect, analyze, and report health care data related to quality, cost, and health equity.