Quality Metrics

CMS is tightening the link between quality measurement, chronic disease management, and payment: the Trump administration is expanding the technology-enabled ACCESS model in 2027 to include COPD, substance use disorder, and tobacco cessation, while signaling interest in broader cross-payer alignment and scalable population health infrastructure for chronic care (ACCESS expansion). At the same time, draft 2027 Medicare Advantage Star Ratings thresholds are becoming harder to meet, and stakeholders including Premier and the Health Care Transformation Task Force are pressing CMS on the CY 2027 PFS/MSSP rule to reduce administrative burden, strengthen primary care and accountable care participation, and maintain quality accountability without overwhelming providers (MA Stars thresholds). For ACOs, MA plans, and health systems, the strategic direction is clear: quality performance is becoming more demanding and more operationally embedded, with success increasingly dependent on interoperable data, chronic-condition management capabilities, and measurable outcomes across Medicare and Medicaid populations.