CMMI’s New Quality Pathway

CMMI wants to make it easier and more effective to measure quality

What

The Center for Medicare and Medicaid Innovation (CMMI), which pilots alternative payment models for the federal health programs, announced a new “Quality Pathway” reimbursement design. CMMI is supposed to evaluate models on how much they save the federal government money and/or whether they improve quality of care — and then expand the ones that do. To date, the agency has been successful in creating savings while maintaining quality of care levels in only four payment models over the last 10 years.  The new Quality Pathway is designed to better assess quality and make it easier to expand models that improve it. It addresses gaps by integrating patient feedback into assessments rather than relying solely on claims data. Specifically, the new Quality Pathway is focused on outcomes and experience measures.

When

CMMI announced the new Quality Pathway on April 17, 2024.

Key Highlights