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GIC hears statewide push to align quality measures; Chapter 343 will require a mandatory state measure set
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Summary
A guest presentation from Michael Bailit reviewed the Quality Measurement Alignment Task Force (QMAT), the state’s aligned measure set and related health‑equity data standards. Speakers told the commission that the governor signed Chapter 343 mandating a state‑adopted quality measure set and directing CHIA to convene a Statewide Quality Advisory
The Group Insurance Commission received an update on statewide efforts to standardize clinical quality measurement and to expand health‑equity reporting.
Michael Bailit, president of Bailit Health, told commissioners that the Quality Measurement Alignment Task Force (QMAT)—a multi‑stakeholder body convened by the Executive Office of Health and Human Services (EOHHS) with CHIA and the Health Policy Commission—built a voluntary aligned measure set for payers and providers, and that the governor signed Chapter 343 into law on January 7. Under that statute, the state‑adopted measure set will move from voluntary to mandatory and CHIA must convene a Statewide Quality Advisory Committee; the transition is expected to be phased with mandatory use for global budget‑based risk contracts beginning in 2027.
Bailit summarized QMAT’s work: an annually reviewed core set of six high‑priority measures (including a CG‑CAHPS consumer experience survey, child immunization status, blood‑pressure and blood‑sugar control measures, and two behavioral‑health screening/follow‑up measures), and an expanded menu of additional measures payers may adopt. He said fidelity to the aligned set has risen from about 72% in 2020 to about 94% statewide in 2025 on an all‑payer basis; UnitedHealthcare was an outlier at about 53% fidelity because national insurers often do not adapt measures to a single state.
On health‑equity data standards, Bailit said a 2022 technical advisory group recommended standards for collecting race, ethnicity, language, disability status and sexual‑orientation and gender‑identity (SOGI) variables and that data completeness remains uneven. He and GIC staff emphasized that measurement depends on consistent, member‑reported demographic data; until collection and validation are strong, the task force has held back public reporting of stratified results. The task force has asked accountable care organizations (ACOs) to voluntarily share stratified performance data with CHIA; those submissions revealed disparities but the data were not yet published because of concerns about validity and completeness.
Margaret Anschutz, GIC staff, described how the commission is using QMAT measures in carrier contracts as performance guarantees and is requiring carriers to achieve or maintain NCQA health‑equity accreditation. She reported that Health New England and WellPoint had achieved accreditation; MGB Health Plan was making progress. Anschutz also outlined GIC plans to pursue maternal‑health interventions targeted at observed disparities (doula coverage and virtual doulas, behavioral‑health services for pregnant and postpartum people, and provider payment models to reduce elective C‑section rates), and said the GIC is aligning its work with EOHHS, MassHealth and the Health Policy Commission.
Commissioners asked about the timing for public reporting of stratified measures (Bailit said a validation effort ran into data‑sensitivity issues and the schedule slipped), about disability status collection (noted as especially undercollected), and about opportunities to hold payers and providers contractually accountable for reducing gaps. Several commissioners urged continued work on data collection and more frequent dashboard reporting from staff even while acknowledging the limitations of imperfect data.
No new regulatory action was decided at the meeting; the presentation and discussion focused on implementation steps, alignment with state agencies, and GIC contractual leverage to promote measurement and accreditation.
