The Trump administration announced Friday that it is launching a new partnership with 37 states that aims to rethink how quality is measured in Medicaid and CHIP.
The Centers for Medicare & Medicaid Services said that the effort aims to put health outcomes "at the center of how success is defined." The agency said in May 2026 it conducted an analysis across 42 states and their managed care programs, which found 450 reporting requirements tied to about 260 unique quality measures across programs.
Variations between states can add to the administrative burden as well as make it difficult to compare performance between states, CMS said.
It's with that backdrop that the agency created the Investing in Health Outcomes program, according to the announcement. Under the initiative, states agree to a voluntary quality pledge that centers on four key elements.
First, they pledge to put health outcomes above processes, emphasizing things like prevention, chronic disease management and behavioral health. Participating states also agree to streamline quality measures without reducing accountability, according to the announcement.
In addition, the states in the program pledge to push toward digital quality measurement and align financial results to outcomes.
“For too long, Medicaid has measured whether boxes are checked instead of whether patients are getting healthier—that must change,” said CMS Administrator Mehmet Oz, M.D., in the announcement. “We should judge success by what matters—preventing disease, managing chronic conditions, and improving patients’ health.”
The agency said they intend the four central principles to "represent a north star vision for Medicaid quality" that will be used as a foundation for future state implementation. The initial participant states have agreed to use these pledges to bring outcomes-oriented measures into their strategies.
CMS added that it plans to hold additional workshops this year on quality measurement.
The news comes at a time where states are neck-deep in implementation for nationwide work requirements that are set to take effect on Jan. 1. The rollout of these requirements means that states need to build significant infrastructure to manage the eligibility checks and determinations.