Clinical care suffers during pandemic in Minnesota

Clinics struggled to treat chronic conditions such as diabetes and asthma in 2020, but a new Minnesota report card shows some managed better than others through the first year of the pandemic.

Minnesota Community Measurement (MNCM) on Tuesday published performance measures for medical groups in 2020 across nearly two dozen measures of health care — after suspending its clinic grading for a year because of the pandemic.

Declines were expected given the shutdown of clinics in spring 2020 during the first COVID-19 wave and the hesitancy of patients to seek routine medical care in the months of the pandemic that followed, said Julie Sonier, MNCM's president and chief executive.

"It remains to be seen how fast Minnesota's health care system will recover," she said.

Optimal diabetes care is measured by whether clinics' patients maintain adequate blood sugar and blood pressure, take aspirin and cholesterol-lowering drugs when recommended and avoid smoking. The share of patients at optimal health declined from 45.4% in 2018 to 40.6% in 2020. While most patients maintained their medication and nonsmoking habits, the share with adequate blood pressure declined from 83% to 76%.

Grades varied widely, with France Avenue Family Physicians in Edina keeping 56% of diabetic patients at optimal health while five groups serving mostly urban and low-income populations had rates below 20%.

HealthPartners extended prescription refills in 2020 so patients could manage their conditions, but delayed preventive care visits for patients because some clinics were closed or converted for COVID-19 testing or treatment of only respiratory illnesses.

The Bloomington-based medical group was above average in 23 of 31 measures of quality overall but saw its share of optimally managed diabetes patients decline from 49.4% in 2019 to a below average 38.7% in 2020.

"The same staff that otherwise would be doing outreach, we needed to ask them to help us with COVID testing and with immunization," said Dr. Beth Averbeck, HealthPartners' senior medical director for primary care.

Popular options such as same-day mammograms were suspended because "you couldn't just have people waiting in the lobby," she added. HealthPartners' breast cancer screening rate still stayed above average at 82.3%

This year's grades do not include performance scores for individual clinics in large groups such as HealthPartners because so many of them were repurposed for emergency uses during the pandemic, Sonier said.

Screenings for adolescent depression declined, but scheduled immunizations for children and teens held steady as providers focused on keeping them protected from respiratory diseases. Performance varied from 86.7% of children receiving scheduled immunizations at South Lake Pediatrics to below 50% at four other medical groups.