Quality Metrics

CMS is expanding the Medicare ACCESS Model in 2027 to additional chronic conditions—including COPD, substance use disorder, and tobacco cessation—signaling a broader Trump administration push to test tech-enabled, condition-based payment models and potentially align them across Medicaid and commercial payers (Healthcare Dive). At the same time, CMS is pressing states to shift Medicaid quality measurement toward outcomes, while NCQA’s 2026 Health Plan Ratings and new survey data on fragmented payer data infrastructure underscore a core VBC tension: purchasers and regulators want more outcome accountability, but many plans still lack the integrated data systems needed to manage performance reliably (Healthcare Innovation).