Association between the Covid-19 Pandemic and Healthcare Quality in the Medicare Shared Savings Program: Insights from Medicare’s Largest Value-Based Payment Model (2016-2022)

Xiyuan Hu, University of Wisconsin at Madison
Mariétou Ouayogodé, University of Wisconsin-Madison

Potential changes in healthcare quality resulting from variation in pandemic severity since 2020 have received less attention. This study aims to assess the association between the pandemic and healthcare quality in Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs). Our year-by-year difference-in-difference event study of Medicare Shared Savings Program (MSSP) participants between 2016 and 2022 (N=3394) indicated that total quality score decreased by 0.83% (95% CI, -0.21% to -1.44%) per standardized cumulative COVID-19 incidence (SCI) in 2020 compared to 2019 but has returned to pre-pandemic level since 2021 after controlling for confounders. The reduction in quality score was mostly driven by ACOs with the highest COVID-19 incidence and in the Midwest region. Our results, suggesting a reversal of the decrease in quality performance one year after the start of pandemic, also add to previous finding about healthcare system resilience and adaptability based on the health service need and utilization.

Keywords: Population, Shocks and Pandemics, Health and Morbidity, Inequality, Disadvantage and Discrimination, Longitudinal studies

See paper.