Quality Reporting After the Headlines: What 2025 Really Changed and What Comes Next

What an interesting year 2025 was. From a regulatory perspective, any year that begins with a change in political parties is bound to bring significant healthcare regulatory change along with it. And while healthcare was frequently in the news this year, the major headlines focused on topics such as the restructuring and elimination of jobs at HHS and the CDC, ACA subsidies, how AI will revolutionize healthcare, and the ever-out-of-reach goal of burden reduction.

For Quality leaders focused on regulatory reporting, I’m not sure “burden reduction” or “AI innovation” come to mind as the defining outcomes of 2025. There were a few reduced requirements, but if anything, the landscape feels more fragmented, more complex to interpret, and increasingly dependent on strong operational infrastructure.

Here’s my perspective on several regulatory themes that mattered most to Quality leaders in 2025, and what they signal as we head into 2026.

Reporting Reduction: Less on Paper, Not Necessarily Less Work

One of the most talked-about themes in 2025 was the reduction in reporting requirements. CMS issued multiple announcements highlighting burden reduction, and on paper, several measures and entire domains were removed from programs like IQR, OQR, and IPFQR.

Despite the headlines, most quality leaders that I talk to do not feel that their workload is decreasing heading into 2026. If anything, it has become harder to keep track of what is required and who is responsible. What used to feel more aligned across CMS, The Joint Commission, and state programs is now more fragmented. Understanding which measures apply to which programs, in which year, and for which organization takes more effort than before.

One clear example is health equity reporting. CMS removed health equity measures from its hospital quality programs, which made news across the industry. However, many hospitals had already invested significant time and resources into building workflows, collecting data, and integrating Health-Related Social Needs into their operations.

More importantly, CMS is not the only driver. States, accreditation bodies, and other entities continue to require health equity-related data. As a result, this work is not going away. Hospitals already have the systems in place, and most continue to collect and use this information.

There is also a broader concern. Without CMS requiring these data elements at a national level, it becomes harder to assemble a comprehensive view of how Health-Related Social Needs affect populations across the country. Factors like food insecurity, housing stability, transportation access, utilities, and exposure to interpersonal violence all have clear implications for patient outcomes. Losing a standardized national dataset makes research and large-scale policy analysis more difficult.

At the same time, local and regional efforts continue, and many hospitals are working closely with community-based organizations to connect patients to the resources they need. While the federal requirement may be gone, the work itself is not.

The Joint Commission and Accreditation 360

Another major development in 2025 came from The Joint Commission with the launch of Accreditation 360. The Joint Commission framed this initiative as a significant simplification, announcing the removal of roughly 700 duplicative standards and questions. The goal was to streamline the accreditation process and reduce administrative burden.

As part of this broader initiative, The Joint Commission also made substantial changes to the ORYX measure set. Most of the ORYX library was eliminated, leaving only required measures. They also added hospital harm measures related to hyperglycemia and hypoglycemia, and introduced a new measure, PC-08, Timely Treatment of Severe Hypertension.

At the same time, The Joint Commission retired 13 eCQMs and 13 abstracted measures from ORYX. Many of these measures had already been retired by CMS and will likely have minimal operational impact for most hospitals.

The changes to the Perinatal Care measure set raised more concern. The Joint Commission retired both the abstracted and eCQM versions of PC-01, Elective Delivery, and PC-05, Exclusive Human Milk Feeding. They retained PC-02, Cesarean Birth; PC-06, Unexpected Complications in Term Newborns; and PC-07, Severe Obstetric Complications.

Many hospitals still track the full Perinatal Care set, often using abstracted measures to supplement eCQM performance. While The Joint Commission will remain the measure steward for PC-01 and PC-05 in 2026, it is notable that these measures were removed at a time when maternal health remains a national priority.

New Payment Models Become Core CMS Programs

The most significant structural shift in 2025 was the continued movement of alternative payment models from pilot programs into the core CMS landscape. The Transforming Episode Accountability Model (TEAM) and the newly finalized Ambulatory Specialty Model (ASM) represent a clear signal that CMS is applying lessons learned from prior Center for Medicare Medicaid Innovation (CMMI) voluntary models at a national scale.

Both models begin with subsets of mandatory participants rather than applying universally. CMS has stated that successful performance could lead to expansion over time. For organizations not selected in the initial cohorts, these models remain important to monitor closely, as future participation may become mandatory.

TEAM applies to hospitals and began in January 2026. ASM applies to ambulatory specialists and starts in January 2027. Despite differences in structure and setting, the models share several core characteristics.

Both incorporate two-sided risk, where success is measured based on both cost and quality. CMS tracks total beneficiary spending attributed to the hospital or provider and compares it against targets. Performance on quality measures is then used to adjust financial outcomes.

In practical terms, success in either model depends heavily on care coordination. Organizations must manage episodes that extend beyond a single encounter and across care settings. Quality reporting is no longer a standalone activity. It is directly tied to financial performance and operational workflows.

Artificial Intelligence: Real Momentum, Real Constraints

Artificial intelligence accelerated rapidly in 2025. The range of use cases expanded in ways that would have been difficult to imagine even a few years ago. On a personal level, AI has enabled individuals without formal technical training (like me) to build tools, analyze information, and solve problems that once required specialized skills.

This year demonstrated that subject matter expertise combined with AI can be powerful. Years spent understanding regulations, reading rules, and tracking measure changes can now be translated into functional tools by simply explaining the problem to an AI bot. That shift is meaningful.

Across healthcare, the promise of AI is significant, and many examples emerged in 2025 showing improvements in efficiency, clinical support, and operational insight. Medisolv also announced plans to incorporate AI into its abstracted measure software in 2026. For quality teams, this has the potential to reduce chart abstraction time and allow for larger or more representative samples.

At the same time, the reality for many quality leaders remains constrained. Many leaders are using AI primarily for administrative tasks such as meeting summaries, drafting content, or building presentations. The broader vision of AI transforming quality work and patient outcomes has not yet fully materialized for most organizations.

Security concerns are a significant factor. Many health systems restrict AI use to tools approved by their security teams. In many cases, that means Microsoft Copilot. While useful, it represents only a small portion of what AI tools can do. As a result, many quality leaders have not had the opportunity to experiment, explore, and discover how AI might reshape their daily work.

Looking Ahead to 2026

As 2026 approaches, quality reporting will continue its steady evolution, shaped by incremental progress rather than sweeping transformation. Based on the most recent proposed rule from ONC related to FHIR capabilities in EHRs, we may finally see the option to specify one or more eCQMs for submission as FHIR eCQMs. CMS has been clear that it does not intend to mandate an immediate switch, instead allowing hospitals several years to transition. Still, it’s fair to ask whether 2026 will mark the first real step in that direction.

FHIR eCQMs would represent meaningful progress toward CMS’s broader vision for digital quality measurement. At its core, that vision centers on pulling quality data directly from hospital and provider EHRs. But realizing it will require bringing the entire healthcare ecosystem along for the ride. Small community hospitals, critical access hospitals, and rural providers will continue to face challenges securing the funding and staffing needed to support fully interoperable technologies. This is not a shift I expect to happen overnight in 2026, but rather the result of continued, incremental pushes that gradually move the market forward.

On the measures front, this year’s Measures Under Consideration (MUC) list included another hospital harm eCQM: Hospital Harm - Postoperative Venous Thromboembolism. This was one of the measures I was expecting. With its inclusion, we are now just one measure away from the TEPs’ articulated vision of a composite Safety eCQM to replace PSI-90. That milestone feels increasingly within reach.

CMMI will also remain firmly in the spotlight. Neither political party seems particularly fond of CMMI… until they’re in power and can use it to test new, innovative models aligned with their priorities. That dynamic is playing out yet again. In April, the Ways and Means Committee sent a letter to CMS Administrator Dr. Mehmet Oz and CMMI Director Abraham Sutton expressing concern over the Center’s history of developing costly models that “either fail to meet or are not on track to meet” statutory standards.

But by the end of 2025,  we find ourselves with a growing list of new and continuing models: ACCESS, MAHA ELEVATE, WISeR, AHEAD, GUIDE, alongside TEAM and ASM (Healthcare LOVES Acronyms). This signals that experimentation is far from slowing down. It will be interesting to watch how all of these models play out in reality in 2026.

As all of this unfolds, hospitals and provider groups will be asked to do more with less: navigate fragmented requirements, prepare for mandatory value-based models, and thoughtfully integrate new technologies while maintaining security and trust. The organizations best positioned to succeed in 2026 will be those that continue to invest in strong reporting infrastructure and remain adaptable as the regulatory landscape continues to shift.