Person-Centered Outcome Measures Are Approved for HEDIS MY 2027
August 5, 2026 · NCQA Communications
NCQA is ready to roll out the person-centered outcome (PCO) measures in HEDIS® MY 2027 for Dual-Eligible Special Needs Plans (D-SNP) and Chronic Condition Special Needs Plans (C-SNP). Unlike traditional care process measures, the PCO measures incorporate the person’s voice into the care plan and quality measurement.
“We have an enormous opportunity to continue to shift quality and performance measurement toward the things that people experience in their day-to-day lives and to empower patients to express what quality means to them,” says Dr. Vivek Garg, NCQA’s President and CEO. “Including person-centered outcome measures in HEDIS represents an important step forward, supporting health plans and care delivery organizations in focusing on what truly matters to patients.”
What Are PCO Measures?
NCQA developed the PCO measures to work in tandem with clinical care, helping older adults and other people living with complex care needs make progress toward a goal that matters most to them. The measures have gone through extensive testing and have been implemented with over 30,000 patients, 750 clinicians, 40 care delivery systems and 17 states.
The PCO measures fit within the broader context of an age-friendly health system because they focus on what matters to the individual and their family and caregivers, which is the “What Matters” of the 4M’s of age-friendly care.
The PCO measures are approved for inclusion in HEDIS MY 2027 and will be reported using the Electronic Clinical Data Systems (ECDS) reporting method. The three measures are:
- Goal Identification (GID-E). The percentage of persons 18 years of age and older with a complex care need who set a person-centered outcome goal.
- Goal Follow-up (GIF-E). The percentage of persons 18 years of age and older with a complex care need who set a person-centered outcome goal and followed up on the goal.
- Goal Achievement (GIA-E). The percentage of persons 18 years of age and older with a complex care need who set a person-centered outcome goal and achieved the goal.
Note: GIA-E will remain in first-year reporting status for at least two years, so 2030 would be the earliest year for public reporting of this measure.
How Are PCO Measures Relevant to Special Needs Plans?
NCQA chose to implement PCO measures with special needs plans because of the close alignment with existing care delivery practices and the Model of Care required by the Centers for Medicare & Medicaid Services. We interviewed seven plans, including both C-SNP and D-SNP, to gather insights to inform the integration of PCO measures into HEDIS.
“Feedback from the plans was generally positive. The PCO approach aligns with the SNP mission to deliver person-centered care and existing workflows around goal setting and care plans,” says Daniela Lawton, NCQA’s Assistant Vice President of Quality Sciences Integration. “Some plans were concerned about the implementation timeline, potential burden on clinicians and the challenge of trying to contact all members for goal setting, and NCQA considered this feedback as we developed our strategy.”
Earlier this year, NCQA tested the PCO measures with two D-SNP plans to confirm that the measures are feasible, adaptable to diverse systems and capable of driving person-centered care. Read our blog, NCQA Tests Person-Centered Outcome Measures With D-SNP Plans, to learn more about the testing and get tips for how to implement the measures.
How Did NCQA Incorporate Public Comment Feedback?
Public comment is an important step in the process of adding new measures to HEDIS. NCQA received comments about the PCO measures from 91 individuals and organizations and the majority of comments were supportive. Positive comments cited that the measures capture meaningful outcomes, support whole-person care, align with existing policy requirements and fill a measurement gap for people with complex needs.
One area of concern relates to feasibility, data capture and interoperability challenges. That’s why NCQA co-developed the Person-Centered Outcome Implementation Guide to provide direction for reporting goals and the PCO measures using FHIR® resources. It includes the steps to document goal-directed care, such as recording a goal, using goal attainment scaling or a patient-reported outcome measure to track goals over time and goal follow-up.
Another concern relates to the administrative burden of the measures—both on health plans and clinicians. The alignment between PCO measures and the CMS Model of Care is achieved by leveraging existing care management workflows and documentation processes wherever possible. NCQA’s testing with D-SNPs demonstrated that organizations can implement the measures without substantial burden. We also pushed back the potential to publicly report Goal Achievement (GIA-E) to no earlier than 2030 to allow plans time to focus on the process of setting standardized goals and following up on them.
“PCO measures have been tested a great deal and they’ve been tested successfully,” says Lawton. “We are excited to release them in HEDIS MY 2027 and we hope to expand implementation of the PCO measures for other populations, including people with behavioral health conditions.”
Learn More
Visit our website to learn more about the PCO measures and how to implement them in your organization.
Acknowledgements
NCQA developed person-centered outcome measures with support from The John A. Hartford Foundation, the SCAN Foundation and the Gordon and Betty Moore Foundation.
We appreciate support from corporations and foundations that share our values and are committed to advancing our mission to improve the quality of healthcare. For more information about partnership opportunities, please contact Erin Oganesian, Assistant Vice President, Quality Solutions Group at eoganesian@ncqa.org.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
HL7® and FHIR® are the registered trademarks of Health Level Seven International and their use does not constitute endorsement by HL7.
