Patient care quality can be measured through many signals: whether treatment plans are documented, whether patients avoid preventable harm, whether chronic conditions are controlled, and whether people receive timely preventive services. The CMS 2024 National Impact Assessment Report provides measures across hospice, nursing, hospital, Medicare, Medicaid, Marketplace, and accountable care organization populations. The periods and populations differ, so each statistic below keeps its original context.
Table of contents
- Care planning and daily function
- Safety in hospitals and long-term care
- Readmissions and post-discharge outcomes
- Medication adherence and review
- Chronic disease management
- Screening and vaccination
Care planning and daily function
Care planning and functional support are central parts of patient care, especially for people receiving hospice or post-acute services. In the CMS 2024 National Impact Assessment Report, documentation improved across several hospice measures during 2016–2021.
The hospice item set and claims check improved documentation for 1.1 million Medicare fee-for-service and Medicare Advantage hospice claims or assessments. The measure increased from 78.5% to 94.8%. Nearly 2.0 million medication reviews were also better documented, while timely medication reviews for hospice claims or assessments increased from 19.1% to 40.1%.
For Medicare fee-for-service beneficiaries, hospice medication reviews rose from 61.3% to 83.3%. Hospice treatment plans improved for 899,098 more Medicare fee-for-service beneficiaries, rising from 69.2% to 82.7%. Among Medicare Advantage beneficiaries, treatment-plan performance improved from 70.9% to 86.1%, representing 1.1 million more beneficiaries with improved plans.
The same report records changes in everyday functional status. Ambulatory functional status for locomotion improved from 71.1% to 81.2% for 1.5 million beneficiaries. Self-management of oral medications improved from 60.9% to 78.0% for 2.1 million beneficiaries. Bathing improved from 74.2% to 82.3% for 873,011 beneficiaries, while bed transferring improved from 68.1% to 81.2% for 1.4 million beneficiaries. Dyspnea performance improved from 72.9% to 82.9% for 885,996 beneficiaries.
Nursing-home measures show more modest changes and also illustrate why direction matters. Short-stay nursing-home residents improved in function from 63.1% to 66.9% over the pre-COVID trend period. Among long-stay nursing-home residents, the share needing assistance with activities of daily living declined from 15.5% to 14.9%.
Safety in hospitals and long-term care
Patient safety statistics include infections, falls, restraints, and other events that can affect recovery or daily wellbeing. The CMS 2024 National Impact Assessment Report estimates 130,050 fewer Clostridioides difficile infection cases across healthcare-associated infection measures. The associated estimated costs avoided ranged from $564.3 million to $2.6 billion.
The reductions were recorded in specific settings as well. Long-term care hospitals had 8,207 fewer C. difficile infections, and inpatient rehabilitation facilities had 3,982 fewer. There were also 6,145 fewer colon surgical-site infections, with estimated costs avoided ranging from $176.7 million to $585.2 million.
Several facility-level safety measures moved in the preferred direction:
| Measure and setting | Reported change |
|---|---|
| Physical restraint use in long-term care hospitals | 0.6% to 0.2% |
| Urinary tract infection rates in long-term care hospitals | 3.9% to 2.5% |
| Major-injury falls in inpatient rehabilitation facilities | 0.2% to 0.1% |
| Inpatient rehabilitation facility falls | 352 fewer events; 0.7% decrease |
| Long-term care hospital falls | 99 fewer events; 10.5% decrease |
| Skilled nursing facility falls | 0.7% decrease; 9,005 fewer falls |
Not every measure improved. Long-stay nursing-home falls increased by 0.9%, which the report identifies as deterioration rather than improvement. This distinction is important: a patient care assessment should show both progress and areas where risk increased.
Readmissions and post-discharge outcomes
Readmissions and emergency care after discharge provide another view of patient care transitions. Among Medicare Advantage enrollees, hospital readmissions fell by 22,617, and the rate improved from 11.5% to 10.8%. The estimated costs avoided for that Medicare Advantage improvement ranged from $385.6 million to $395.8 million. By comparison, readmissions among Medicare fee-for-service patients remained broadly stable, moving from 15.3% to 15.5% during the analysis window.
Procedure-specific readmissions also declined. Acute myocardial infarction readmissions fell from 16.3% to 15.2%, preventing 3,448 readmissions. Coronary artery bypass graft readmissions fell from 13.8% to 12.1%, preventing 1,632 readmissions. Hip and knee arthroplasty readmissions fell from 4.4% to 4.1%, preventing 2,062 readmissions.
Post-discharge complications after hip and knee arthroplasty fell from 2.8% to 2.4%, preventing 1,931 complications. Emergency department visits after hospital discharge fell from 44.8 to 43.3 per 1,000 beneficiary months. Among Medicare fee-for-service patients aged 65 and older, there were 11,417 fewer 30-day deaths after hospitalization for heart failure, acute myocardial infarction, stroke or cerebrovascular accident, and coronary artery bypass graft procedures.
These measures describe population-level changes, not guarantees for an individual patient. They also cover different conditions, insurance groups, and time windows, so the values should not be combined into a single overall rate.
Medication adherence and review
Medication-related care appears in both hospice documentation and broader adherence measures. The CMS 2024 National Impact Assessment Report found improved statin adherence for 3.7 million more Medicare enrollees, with estimated costs avoided of $11.6 billion. Statin adherence also improved for 234,474 Marketplace members, with $732.5 million in estimated costs avoided.
Diabetes-medication adherence improved for 857,402 more Medicare enrollees. The estimated costs avoided ranged from $505.9 million to $1.8 billion. Among Marketplace members, diabetes-medication adherence improved for 104,005 more people, with estimated costs avoided ranging from $61.4 million to $214.4 million.
Adherence to renin-angiotensin system antagonists improved for 3.2 million more Medicare enrollees. The estimated costs avoided ranged from $12.4 billion to $15.8 billion. RAS-antagonist adherence also improved for 104,894 more Marketplace members; the report does not provide a corresponding cost estimate for that Marketplace measure.
Medication review after discharge improved from 89.6% to 91.8%. In hospice care, timely medication reviews rose from 19.1% to 40.1% for hospice claims or assessments, while Medicare fee-for-service hospice medication reviews rose from 61.3% to 83.3%. These are related medication-care measures, but they are not interchangeable: one concerns timing after discharge, while the hospice figures concern hospice populations and documentation or review performance.
Chronic disease management
Patient care outcomes also depend on managing diabetes, blood pressure, respiratory disease, and other chronic conditions. Among accountable care organization patients, poor hemoglobin A1c control improved from 18.4% to 13.9%, representing 145,149 fewer enrollees with poor control. Among Medicare Advantage enrollees, poor A1c control improved from 23.2% to 19.6%, representing 193,741 fewer patients with poor control.
Medicaid poor hemoglobin A1c control was stable within the reported range, from 39.3% to 37.5%. Marketplace hemoglobin A1c control improved from 53.9% to 57.0%. Because the report uses different populations and definitions for these measures, the percentages should be read within their named programs.
Blood pressure control among accountable care organization patients improved from 70.6% to 74.9%, producing 396,902 more patients with controlled blood pressure. Among Medicaid enrollees aged 40–64, COPD or asthma inpatient admissions fell from 93.5 to 62.8 per 100,000 beneficiary months.
Taken together, these measures show several ways to evaluate chronic-care performance: the proportion with poor control, the proportion with controlled blood pressure, and the rate of condition-related inpatient admissions. They represent different outcomes and should remain separate when interpreting patient care statistics.
Screening and vaccination
Preventive care measures capture services intended to identify risk or prevent illness before a more serious episode occurs. Among Medicare fee-for-service patients, influenza vaccination improved from 68.0% to 80.1%, adding 3.4 million vaccinated beneficiaries.
Colorectal cancer screening among Medicare fee-for-service patients improved from 61.4% to 70.4%, adding 1.1 million screened beneficiaries. Breast cancer screening improved from 67.4% to 73.4%, adding 194,000 screened beneficiaries. Adolescent immunization completion improved from 13.4% to 23.3%.
Depression screening among Medicare fee-for-service patients improved from 54.3% to 70.2%, adding 3.6 million more screened beneficiaries. These screening figures indicate service delivery at the population level; they do not state how many people received a diagnosis or treatment as a result.
The CMS 2024 National Impact Assessment Report therefore presents patient care as a set of measurable processes and outcomes. Documentation, functional ability, safety events, readmissions, medication use, chronic disease control, vaccination, and screening each contribute a different piece of the picture. The clearest interpretation keeps the population, geography or program, measurement period, and direction of change attached to every statistic.