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Excellent Health Outcomes for All (Part C and D). CMS plans to update the Health Equity Index (HEI) reward defined at §§ 422.166(f)(3) and 423.186(f)(3) to call it the Excellent Health Outcomes for All (EHO4all) reward because this name better captures the goal of ensuring exceptional care for all enrollees. The enrollees to be included in the EHO4all when it is implemented beginning with the 2027 Star Ratings include those that are dually eligible, receive a low-income subsidy, or are disabled because these groups are at risk for poor health outcomes and Star Ratings data show gaps in the quality of care for these enrollees. While the EHO4all reward incentivizes improved performance among specified groups of enrollees at risk for poor health outcomes, CMS is also incentivizing improved performance across all enrollees by removing the current reward factor when the EHO4all reward is implemented beginning with the 2027 Star Ratings. This is consistent with the goal of achieving excellent health outcomes for all enrollees. CMS is considering adding factors beyond dual eligibility, receipt of low-income subsidy, and disability to the EHO4all reward. One factor we are considering adding is geography (e.g., rural or urban). We solicited preliminary feedback on the addition of geography to the reward and how to define this. There was mixed support for adding geography as an additional factor in the EHO4all reward (also called the HEI reward). Some commenters asked for more details on the definition of geography that would be used, while a few commenters suggested possible definitions of geography. CMS will continue to consider adding geography as an additional factor in the EHO4all reward. Adding geography to the EHO4all reward would need to be proposed and finalized through rulemaking, and a definition of geography would also be proposed as part of this process. Additionally, CMS will propose updates to §§ 422.166(f)(3) and 423.186(f)(3) in future rulemaking to reflect the updated name, EHO4all reward. CMS may also consider additional changes regarding the EHO4all reward and any further changes would need to be proposed through rulemaking. Diabetes Foot Exam and Follow-Up (Part C). NCQA is developing a new measure that assesses comprehensive foot examinations (neurological, vascular, visual) and appropriate follow-up for abnormal findings (sensory loss, poor circulation, visible wounds/ulceration, skin or structural changes) or for those with existing amputation risk (prior deformity, ulceration, or amputation; glycemic status >9%, smoking, retinopathy, nephropathy, ESRD, dialysis) among adults with diabetes. The measure will be implemented as an ECDS-reported measure that leverages multiple data sources (i.e., claims, electronic health records, health information exchanges, registries). The measure may be included in HEDIS starting with the 2027 measurement year at the earliest. There was mixed reaction to this measure, with commenters wanting additional information to evaluate it. We have shared this feedback with NCQA for their consideration. Colorectal Cancer Screening Follow-Up (Part C). NCQA is exploring the development of a measure to assess follow-up after colorectal cancer screening. When identified early, colorectal cancer is one of the most treatable forms of cancer. However, the current Colorectal Cancer