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We also encourage interested parties to provide comments directly to measure developers during their public comment periods. For example, the National Committee for Quality Assurance (NCQA) and the Pharmacy Quality Alliance (PQA) regularly solicit public comments on new measures, changes to existing measures, and measure retirements. Section H. Efforts to Simplify and Refocus the Measure Set to Improve the Impact of the Star Ratings Program As the Part C and D Star Rating program continues to evolve and align with the measures included in the Universal Foundation, we are considering additional ways to simplify and refocus the measure set. This is consistent with recommendations from MedPAC and other interested parties that CMS consider having fewer measures in the Part C and D Star Ratings program. To support the CMS National Quality Strategy, CMS is continuing to move towards a building- block approach to streamline quality measures across CMS quality and value-based care programs. Across our programs, where applicable, we are considering including the Universal Foundation32 of quality measures, which is a core set of measures that are aligned across CMS programs. CMS is committed to aligning a core set of measures across all our quality and value- based care programs and ensuring we measure quality across the entire care continuum in a way that promotes high quality care for all individuals. Improving alignment of measures across federal programs and with private payers would reduce provider burden while also improving the effectiveness and comparability of measures. Using the Universal Foundation of quality measures would focus provider attention, reduce burden, identify care issues, prioritize development of interoperable, digital quality measures, allow for cross-comparisons across programs, and help identify measurement gaps. The Universal Foundation is a building block to which programs can add program-specific measures. This core set of measures will evolve over time to meet the needs of individuals served across CMS programs. We will continue to consider if additional Universal Foundation measures should be included in the Star Ratings program. We are no longer considering adding the Social Need Screening and Intervention (Part C) measure to the display page or proposing it through rulemaking to add to the Star Ratings program. Any additional Universal Foundation measures would need to be proposed through the rulemaking process. The Universal Foundation attempts, among other things, to focus attention on measures that are meaningful for the health of broad segments of the population and to reduce provider burden by streamlining and aligning measures – in other words, to focus the measure set on clinical care, outcomes, and patient experience of care measures. There are various measures currently in the Part C and D Star Ratings measure set that focus on operational performance or on completion of required administrative processes. While these measures have been invaluable to CMS’s efforts to monitor and improve plan performance and compliance in critical operational areas, they may

32 https://www.nejm.org/doi/full/10.1056/NEJMp2215539.