CMS Partners with 37 States to Enhance Medicaid Quality Measurement

The Centers for Medicare & Medicaid Services (CMS) is embarking on a groundbreaking initiative to evolve the way Medicaid and the Children’s Health Insurance Program (CHIP) measures quality. Announced on September 26, 2026, this initiative involves a voluntary Medicaid Quality Pledge as part of a collaboration with 37 states including the State of Oklahoma, State of Colorado, and State of Utah. The primary goal is to transition from traditional process-based metrics to an emphasis on health outcomes, which has profound implications for procurement within the healthcare sector.

For years, the methodology adopted by Medicaid has been criticized for focusing heavily on metrics that assess compliance with processes rather than actual health improvements for beneficiaries. The new approach is aimed at ensuring that CMS and its state partners prioritize outcomes that lead to improved health for individuals receiving care. CMS Administrator Dr. Mehmet Oz noted a significant shift in perspective: “For too long, Medicaid has measured whether boxes are checked instead of whether patients are getting healthier — that must change.” This statement underscores the urgent need for a paradigm shift in accountability within Medicaid systems.

As outlined by CMS Deputy Administrator Stephanie Carlton, the agency is committed to working closely with states to implement strategies that favor health outcomes rather than just fulfilling bureaucratic requirements. The initiative will be supported through workshops and collaborative efforts that aim to enhance the quality of care in practical ways. The focus will be on prevention, chronic disease management, and integration of behavioral health services into primary care frameworks—areas that directly correlate with improved patient health.

Moreover, the program aims to reduce the administrative burden associated with quality reporting. A CMS analysis conducted in May 2026 revealed over 450 reporting requirements across 42 states, which complicated efforts to evaluate performance across different jurisdictions. The initiative seeks to streamline these measures while ensuring that accountability and quality care remain central priorities. By emphasizing digital quality measurement and the use of real-time data, CMS intends to not only simplify reporting but also make it more effective and relevant.

This shift towards a data-driven, outcome-oriented procurement strategy carries significant implications for vendors in the healthcare space. Companies that provide digital health technologies, data analytics services, and innovative solutions tailored to chronic disease management will find new opportunities. Proposals and responses to upcoming solicitations should be aligned with CMS’s vision for prioritizing health outcomes to ensure they are competitive.

The Investing in Health Outcomes initiative outlines four main principles: prioritizing health outcomes, streamlining quality measures, advancing digital metrics, and aligning financial accountability with outcome-based metrics. These principles will collectively serve as a template for future engagements between CMS, state partners, and vendors – ultimately leading to transformative improvements in how Medicaid operations are conducted.

The potential for enhanced procurement opportunities is a keysignal for firms looking to penetrate or expand their presence in the healthcare and Medicaid contracting arenas. Vendors that can demonstrate support for programmatic goals in prevention and health management are likely to be favored in this reoriented landscape of Medicaid quality assurance.

As states begin to adopt this quality pledge, organizations should proactively refine their service offerings aligned with the new CMS priority framework. By concentrating on outcome metrics and developing tools that facilitate real-time data measurement, vendors can position themselves as essential partners in this significant governmental shift.