CMS Sets a Clear Direction for Quality, Safety, and Long-Term Care
The Centers for Medicare & Medicaid Services (CMS) recently released its Center for Clinical Standards and Quality (CCSQ) FY2025–2028 Strategic Roadmap, outlining how the agency plans to strengthen quality, safety, and accountability across the nation’s health and long-term care systems.
At its core, the roadmap reinforces CMS’ foundational role in establishing national standards, advancing quality measurement and improvement, and supporting Medicare coverage decisions. What’s new is the way the Agency is thinking about how to bring the pieces together in a more coordinated strategy.
Five Strategic Priorities
CMS organizes its work over the next several years around five goals:
Prevention
Quality and Safety
Accelerating Coverage
Data and Technology
Burden Reduction
Taken together, these priorities point toward a system that is more proactive, more transparent, and more streamlined for both patients and providers.
What’s Changing and Why It Matters
Prevention as the Starting Point
CMS is placing greater emphasis on ensuring people have early access to screenings, wellness visits, and conversations with their providers. This also includes a more explicit focus on nutrition and lifestyle supports. By aligning guidance with the Dietary Guidelines for Americans and expanding access to nutrition counseling, CMS is reinforcing prevention as a practical, system-wide priority rather than an abstract goal.
This emphasis on prevention also aligns with broader CMS efforts to test new approaches to upstream care. For example, the MAHA ELEVATE (Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence) Model focuses on evaluating evidence-based lifestyle and preventive interventions to prevent or slow the progression of chronic disease. While separate from the CCSQ roadmap, it reinforces a consistent direction across CMS toward expanding access to preventive supports.
Strengthening Quality and Safety Through Accountability
Quality and safety remain central, but the roadmap signals a more assertive approach to accountability. CMS is expanding public reporting so patients can better understand the safety and performance of hospitals and nursing homes before making care decisions.
At the same time, the agency is strengthening oversight across settings, from nursing homes to transplant organizations, and continuing to take enforcement actions when standards are not met. Newer tools, including digital and AI-supported quality measures, are intended to help identify preventable harms like infections or medication errors earlier and more consistently.
Faster, More Transparent Pathways to Coverage
CMS is also focused on closing the gap between innovation and patient access. Through updates to National and Local Coverage Determination processes which may include efforts to streamline review timelines, clarify evidentiary standards, and improve visibility into decision status, the agency aims to make coverage decisions more transparent and easier to navigate.
The intent is not just speed, but clarity. With improved public reporting tools and dashboards, stakeholders will have better visibility into how decisions are made and when changes are coming.
Data and Technology as a Core Enabler
A consistent thread throughout the roadmap is the role of data and technology in making these priorities achievable. CMS is continuing to advance interoperability through FHIR standards, enabling more real-time exchange of information across providers, payers, and patients.
At the same time, the expansion of digital quality measures allows data to be pulled directly from electronic systems, reducing the need for manual reporting. These efforts are paired with growing use of analytics and technology to support oversight and identify opportunities for improvement.
Reducing Administrative Burden
Just as notable is the elevation of burden reduction as a standalone goal. CMS is acknowledging the cumulative impact of reporting requirements and administrative complexity on providers. Efforts here focus on aligning reporting across programs, removing outdated requirements, and using automation to simplify compliance. A key signal to watch will be whether CMS meaningfully retires legacy reporting requirements, particularly as digital quality measurement expands, rather than layering new approaches on top of existing ones. The overarching aim is straightforward: allow providers to spend less time navigating systems and more time delivering care.
This focus on burden reduction is also reflected in broader CMS efforts. The WISeR (Wasteful and Inappropriate Service Reduction) Model, for example, signals a shift toward more targeted and technology-enabled approaches to utilization management, aimed not only at reducing low-value care, but also at minimizing unnecessary administrative friction. Together, these efforts point to a more streamlined approach where oversight is increasingly driven by data and automation rather than manual processes, raising expectations for how organizations manage both compliance and care delivery.
A More Coordinated Approach to System Improvement
None of these priorities are entirely new on their own. What this roadmap does is bring them together into a more cohesive vision for how CMS will operate through 2028.
It reflects a shift toward a system that emphasizes earlier intervention, clearer accountability, better use of data, and fewer administrative barriers. For many organizations, the direction will feel familiar, but the level of coordination and follow-through may raise the bar for execution.
What Organizations Should Be Doing Now
For providers, plans, and partners, this roadmap is a signal of where expectations are heading. Organizations that begin aligning now will be better positioned as these priorities translate into policy, measurement, and oversight changes.
Key areas to focus on include:
Strengthening how prevention is integrated into care delivery
Preparing for expanded digital quality measurement and reporting
Investing in data infrastructure and interoperability
Streamlining administrative and reporting workflows
Monitoring evolving coverage policies and CMS guidance
Turning Strategy into Action
CMS is raising expectations for how organizations deliver, measure, and improve care. Coral helps organizations align with these priorities by strengthening quality strategies, advancing data and reporting infrastructure, and preparing for more digital, interoperable measurement.
Now is the time to move from awareness to action. Let’s talk about how to position your organization for what’s next.