Adherence to medications for cholesterol, hypertension, and diabetes helped Medicare beneficiaries avoid up to $29.2 billion in healthcare costs over six years (2016-21), according to the 2024 National Impact Assessment of CMS Quality Measures Report. This report underscores the importance of high-impact measures for chronic conditions, as evidence-based management efforts can significantly reduce complications and mortality.

Developed by PQA, these health plan measures ensure patients have their prescribed medications, directly contributing to the Medicare Part D Star Ratings program. Improved adherence has led to fewer fatal cardiac events, hospitalizations, and readmissions, highlighting the tangible benefits for patients. Adherence for those enrolled in the Health Insurance Marketplace also saved up to $1.46 billion.

The report found disparities across race and ethnicity, dual eligibility for Medicare and Medicaid, urban or rural residence, and socioeconomic conditions. Progress is noted, such as closing the adherence gap for Black or African American individuals in traditional Medicare and Part D programs regarding statin prescriptions for diabetes.

PQA launched a Health Equity Technical Expert Panel to address these disparities to ensure equitable healthcare. We will share a report on their work later this year. Read more about this report in PQA CEO Micah Cost’s article in Managed Healthcare Executive