Quality Metrics & Safety

CMS is tightening the quality-and-safety infrastructure around VBC by moving MSSP and QPP policy toward digital, interoperable measurement—especially a 2027–2030 path for FHIR-based ACO quality reporting—while also using model design, including mandatory joint replacement and specialty models, to tie performance accountability more directly to care episodes and outcomes. ACOs, health systems, and payers should treat this as a multi-year operating shift: quality reporting, prior authorization, patient-reported/person-centered outcomes, and AI-enabled risk analytics are converging into the same data stack, raising near-term investment pressure and longer-term differentiation opportunities for organizations that can produce trusted, auditable performance data. The strategic tension is that CMS is expanding measurement sophistication and safety accountability even as Medicare Advantage Stars litigation and stakeholder pushback underscore how financially consequential—and contested—quality scoring has become (Wakely on MSSP digital quality timeline; Health Affairs on MA Stars litigation).