Quality Metrics & MIPS

Quality measurement is becoming a flashpoint in VBC as the Trump administration’s CMS weighs FY 2027 IPPS/LTCH PPS policies and specialty models: Premier and HCTTF are pressing CMS to pair hospital payment adequacy with more workable quality requirements in TEAM, CJR-X, and inpatient measures, while ACC is seeking changes before the 2027 Ambulatory Specialty Model launch to avoid misaligned specialty accountability. At the same time, MA Star Ratings and preventive measures remain strategically unstable—court challenges, debate over diabetic eye exams, and social-needs measurement all point to rising tension between measure simplification, equity goals, and plan/provider revenue exposure. For ACOs, specialty groups, and payers, the near-term signal is clear: quality metrics are not just compliance infrastructure but a core contracting risk, especially as shared-savings models such as kidney care continue to tie performance scores directly to financial outcomes (Premier comments on FY 2027 IPPS; HCTTF comments to CMS).