The Centers for Medicare & Medicaid Services on Sept. 25, 2026, announced Investing in Health Outcomes, a voluntary partnership with 37 founding states to rewrite how Medicaid and CHIP define quality. CMS says success should turn on health outcomes — prevention, chronic disease management, and behavioral health — rather than process checklists.
A May 2026 CMS review of Medicaid managed care in 42 states found about 450 reporting requirements tied to roughly 260 unique measures, many focused on utilization and process. Different states even use different A1c cutoffs for diabetes control, the agency said, which makes comparisons hard and reporting heavy.
The four-part pledge
States that sign the Medicaid Quality Pledge commit to: (1) prioritize health outcomes over process; (2) streamline measure inventories without dropping accountability; (3) move toward digital, near-real-time quality measurement instead of claims and chart pulls where feasible; and (4) align financial accountability with outcomes-oriented measures. Participating states will build outcome targets into quality strategies and upcoming procurements. CMS plans workshops later in 2026 on measure prioritization, value-based arrangements, burden reduction, and digital measurement. More detail is posted at medicaid.gov under Investing in Health Outcomes.
Governors from Oklahoma, Colorado, Utah, and Connecticut issued supportive quotes in the release. Founding participants together cover about 56 million Medicaid and CHIP enrollees and roughly $701 billion in fiscal 2024 Medicaid spending, according to coverage of the announcement.
Why this matters for providers and DSPs
I/DD and HCBS agencies already report to state Medicaid agencies, managed care plans, and licensing bodies. A national push to drop process measures and raise outcome and digital reporting will show up in plan contracts, value-based add-ons, and state quality strategies — including where waiver services sit inside managed care. Provider agency leaders and QIDPs should watch whether their state signed the pledge, which measures get cut or added, and how outcome targets might touch incident rates, community inclusion, or chronic-care coordination that DSPs support every day.