Cascade of Meaningful Measures 

CMS continues to evolve Meaningful Measures 2.0 and the Cascade of Meaningful Measures framework to reflect the quality measurement priorities of the Agency.

The Cascade of Meaningful Measures is a framework to help prioritize existing health care quality measures, align or reduce measures where there are too many, and identify gaps where new measures may need to be developed. The framework starts by utilizing the eight health care priorities of the Meaningful Measures 2.0 Framework (Figure 1): Wellness and Prevention; Optimal Care for Chronic Conditions and Acute Events; Person-Centered Care; Safety; Seamless Care Coordination; Closing Gaps of Care; Value, Affordability, and Efficiency; and Behavioral Health.

Figure 1. Meaningful Measures 2.0 Framework

As shown in Figure 2, the Cascade of Meaningful Measures describes, in increased detail, components of the health care system that are being measured. It moves from the eight Meaningful Measures health care priorities to topics and focus areas. Topics and focus areas for each health care priority were identified through peer-reviewed and gray literature searches, as well as stakeholder input. We define these terms below.

• Priorities: These are the eight Meaningful Measures 2.0 priorities for quality measurement and improvement. (Example: Safety)
• Topics: A major subject area within a priority that groups related areas of attention. (Example: Preventable Harm)
• Focus Area: A more specific area within a topic that highlights a particular measurable aspect of care. (Example: Health care-associated infections)

CMS programs leverage the Cascade to identify possibilities for measure alignment and to prioritize areas for additional measure development. As depicted by the right-to-left arrow at the bottom of Figure 2, the Cascade ultimately helps programs move from existing process and outcome measures to the development of more expansive outcome measures and composites at the topic and priority levels.

Figure 2. Cascade of Meaningful Measures Schematic

Additional Resources:

• To search the CMS measure portfolio by priority, topic, or focus area visit the Health Care Priorities page on the CMS Measures Inventory Tool (CMIT)
• Cascade of Meaningful Measures Framework – August 2026 (XLSX)