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Outcomes over checkboxes: The Trump administration is partnering with 37 states to overhaul how Medicaid measures quality. The new "Investing in Health Outcomes" program shifts focus from process metrics to real health results — think chronic disease management and prevention. States are signing a voluntary pledge built around four core principles, with more workshops planned for later this year.
Outcomes over checkboxes: CMS is rethinking how Medicaid measures success
The Trump administration has launched the "Investing in Health Outcomes" program — a voluntary partnership with 37 states aimed at fundamentally reshaping how quality is measured in Medicaid and CHIP. The push comes after a May 2026 CMS analysis of 42 states revealed a tangled web of 450 reporting requirements tied to roughly 260 unique quality measures, creating administrative headaches and making state-to-state comparisons nearly impossible.
Under the initiative, participating states sign a voluntary quality pledge built around four pillars: prioritizing health outcomes over process metrics, streamlining quality measures without sacrificing accountability, advancing digital quality measurement, and tying financial incentives to actual outcomes. CMS Administrator Dr. Mehmet Oz summed it up directly: "We should judge success by what matters — preventing disease, managing chronic conditions, and improving patients' health."
By the Numbers
Why it matters: This shift could reduce administrative burden on states while making Medicaid performance data more meaningful and comparable — though it arrives as states are simultaneously scrambling to implement work requirements set to take effect January 1.
