CMS National Quality Strategy

CMS National Quality Strategy

With the Centers for Medicare & Medicaid Services (CMS) National Quality Strategy, CMS will set and raise the bar for a resilient, high-value health care system that promotes quality outcomes, safety, equity, and accessibility for all individuals, especially for people in historically underserved and under-resourced communities.

What is the CMS National Quality Strategy?

CMS leverages a number of approaches to improve health care across the country, including quality measurement; public reporting; value-based payment programs and models; establishing and enforcing health and safety standards; and providing quality improvement technical assistance.

In 2022, the agency launched the CMS National Quality Strategy, an ambitious long-term initiative that aims to promote the highest quality outcomes and safest care for all individuals. The CMS National Quality Strategy focuses on a person-centric approach from birth to end of life as individuals journey across the continuum of care, from home or community-based settings to hospital to post-acute care, and across payer types, including Traditional Medicare, Medicare Advantage, Medicaid and Children’s Health Insurance Program (CHIP) and Marketplace coverage.

The CMS National Quality Strategy builds on previous efforts to improve quality across the health care system, incorporates lessons learned from the COVID-19 Public Health Emergency (PHE), and addresses the urgent need for transformative action to advance towards a more equitable, safe, and outcomes-based health care system for all individuals.

  • Quality Mission: To achieve optimal health and well-being for all individuals.
  • Quality Vision: CMS, a trusted partner, I shaping a resilient, high-value American health care system that delivers high-quality, safe, and equitable care for all.

CMS National Quality Strategy Priority Areas and Goals

The CMS National Quality Strategy has 4 priority areas, each with two goals. Each goal has associated objectives and targets to support successful implementation. Within each goal, we highlight actions in progress to demonstrate current and planned work.

CMS National Quality Strategy Priority Areas and Goals

Promote Aligned and Improved Health Outcomes

Outcomes: Improve Quality and Health Outcomes Across the Care Journey

Objective: Improve quality in high priority clinical areas and support services.

Success Target: Implement a Universal Foundation of impactful adult and pediatric measures across all CMS quality and value-based programs and across the care journey by 2026, stratified for equity.

Highlighted Initial Actions:

  • Focus on high impact areas: maternal health, mental health, equity, and safety.
  • Deploy comprehensive quality improvement approaches, leveraging evidence-based interventions.
  • Develop dashboards to inform quality improvement, quality performance, and policy decisions.
Alignment: Align and Coordinate Across Programs and Care Settings

Objective: Increase alignment by focusing provider and health care system attention on a universal set of quality measures that address high-priority clinical areas and support services.

Success Target: Promote standardized approaches to quality metrics, quality improvement initiatives, and quality and value-based programs across CMS through use of universal measure sets and aligned quality policies.

Highlighted Initial Actions:

  • Implement relevant measures from the Universal Foundation in applicable CMS quality programs across the care journey by 2026.
  • Pursue greater program alignment across Medicare, Medicaid, Marketplace, and models through standardization of data collection and reporting and stratification by sociodemographic data elements.
  • Collaborate with other federal agencies and external partners (e.g., VA, AHRQ, CDC, CQMC) to promote alignment in quality measurement.

Advance Equity and Engagement for All Individuals

Equity: Advance Health Equity and Whole-Person Care

Objective:  Reduce health disparities and promote equitable care for all by using standardized methods for collecting, reporting, and analyzing health equity data across CMS quality and value-based programs.

Success Target: Incorporate equity into the measurement strategy of every CMS quality and value-based program in order to reward high-quality care for underserved populations, with full implementation to follow in subsequent years.

Highlighted Initial Actions:

  • Collect social drivers/determinants of health (SDOH) data across programs and health care settings.
  • Implement and utilize health equity scores and equity-specific measures, such as the proportion of adults screened for SDOH and a commitment to equity attestation measure. 
  • Support health equity through regulations, standards, oversight, Conditions of Participation, and quality improvement assistance.
Engagement: Engage Individuals and Communities to Become Partners in Their Care

Objective: Ensure individuals and caregivers have the information needed to make the best choices for their health, as well as a direct, significant, and equitable contribution to how CMS evaluates quality and safety.

Success Target: Improve individual and caregiver access to information relevant to health care decision-making and amplify the voice of individuals and communities through expanded outreach and increased use of person-reported measures (comprising a minimum of 25% of the overall measure set or 25% of the overall score calculation weighting).

Highlighted Initial Actions:

  • Expand individual and community outreach efforts to obtain meaningful, bi-directional engagement and include diverse perspectives in CMS strategy and policy.
  • Promote interoperability of health care data to ensure all individuals have access to their personal health information through patient portals.
  • Increase access to and utilization of public reporting websites (e.g., Care Compare) to promote informed and collaborative decision-making.
  • Integrate feedback from individuals and communities through person-reported quality metrics.

Ensure Safe and Resilient Health Care Systems

Safety: Achieve Zero Preventable Harm

Objective:  Improve performance on key patient safety metrics through the application of CMS levers such as quality measurement, payment, health and safety standards, and quality improvement support.

Success Target: Improve safety metrics with a goal to return to pre-pandemic levels by 2025 and reduce harm by an additional 25% by 2030 through expanded safety metrics, targeted quality improvement, patient engagement, and Conditions of Participation.

Highlighted Initial Actions:

  • Implement tracking to show progress towards reducing harm (e.g., healthcare-associated infections) to pre-pandemic levels and beyond.
  • Expand the collection and use safety indicator data across programs, including data on key areas such as maternal health, behavioral health, adverse events, and workforce issues.
  • Align across HHS to implement actions from the President’s Council of Advisors on Science and Technology (PCAST) to further enhance patient safety.
Resiliency: Enable a Responsive and Resilient Health Care System to Improve Quality

Objective: Foster a more resilient health care system that is better prepared to respond to future emergencies.

Success Target: Safeguard vital health care needs by ensuring support for health care workers and systems and addressing workforce issues to reduce burnout and staff shortages.

Highlighted Initial Actions:

  • Implement quality-focused components of the CMS Supporting Health Care Resiliency Cross-Cutting Initiative by 2025.
  • Implement one or more CMS-specific quality actions consistent with the Office of the Assistant Secretary for Health (OASH) work on the Federal Plan for Equitable Long-Term Recovery and Resilience by 2030.

Accelerate Interoperability and Scientific Innovation

Interoperability: Accelerate and Support the Transition to a Digital and Data-Driven Health Care System

Objective: Support data standardization and interoperability by developing and expanding requirements for sharing, receipt, and use of digital data, including digital quality measures, across CMS quality and value-based programs.

Success Target: Transition to all digital quality measures and digital data collection by 2030 to reduce burden and enable timely availability of quality data.

Highlighted Initial Actions:

  • Annually increase the percentage of digital quality measures used in CMS quality programs.
  • Build one or more CMS quality data receiving systems that can receive data using the FHIR standard with API delivery by 2030.
  • Collaborate with ONC to promote interoperability and ensure standardized digital data elements for quality measures through USCDI or USCDI+.
Scientific Advancement: Transform Health Care using Science, Analytics, and Technology

Objective: Support and drive innovation and access through advanced data analytics and streamlined evidence-based reviews of novel technologies and devices for coverage decisions.

Success Target: Utilize advanced data analytic models to support data-driven policy decisions for quality care.

Highlighted Initial Actions:

  • Develop policy options to create an accelerated approval pathway for evidence-based review of novel medical devices relevant to the Medicare population. 
  • Ensure equity in data collection and algorithms by identifying and addressing bias in health care data and applications.

Implementing the CMS National Quality Strategy

The success of this Strategy relies on coordination, innovative thinking, and collaboration across all entities. A unified approach brings us all one step closer to the health care system we envision for every individual.

One lever central to the CMS National Quality Strategy that unifies Traditional Medicare, Medicare Advantage, Medicaid & Children’s Health Insurance Program (CHIP) coverage, Marketplace plans, and CMS Innovation Center models and demonstrations is quality measurement. The Meaningful Measure Initiative, active since 2017, remains key to shaping the entire ecosystem of quality measures that drive value-based care. Working as a one of many initiatives and activities under the CMS National Quality Strategy, Meaningful Measures 2.0 promotes innovation and modernization of all aspects of quality measurement, addressing a wide variety of settings, stakeholders, and measurement requirements. Additionally, the “Universal Foundation”  of quality measures further focuses provider attention, reduce burden, identify disparities in care, prioritize development of interoperable, digital quality measures, allow for cross- comparisons across programs, and help identify measurement gaps by identifying a set of key quality measures to use throughout CMS programs. 

As we continue making progress, CMS will look to federal partners, external stakeholders, contract organizations (such as the Quality Improvement Organizations), private payers, and others to partner with us in the implementation of the goals outlined in the CMS National Quality Strategy.

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Page Last Modified:
02/06/2024 10:14 AM