Click the plus sign (+) for each current technical expert panel (TEP) to learn how to get involved.

Development of Medicaid Total Cost of Care Measure

Project Title: Development of Medicaid Total Cost of Care Measure

Dates: The Technical Expert Panel (TEP) nomination period opens on January 26, 2026 and closes on February 24, 2026. Submit all nomination materials by the closing date.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) contracted Yale New Haven Health Services Corporation – Center for Outcomes Research and Evaluation (CORE) to develop a Medicaid total cost of care (TCOC) measure for use initially in the CMS Innovation Center’s Innovation in Behavioral Health (IBH) Model. The contract name is Quality Measure Development and Analytic Support. The contract number is HHSM-75FCMC18D0042, Task Order HHSM-75FCMC24F0230. As the organizer of this TEP, CORE convenes groups of stakeholders and experts who contribute direction and thoughtful input on their work and analysis. CORE is seeking input from individuals with relevant experience and expertise who can provide a variety of perspectives on the development of this measure. The TEP will provide input and advice on the approach for measuring TCOC for services provided under the IBH Model to adult Medicaid beneficiaries with moderate to severe behavioral health conditions and substance use disorder (SUD).

Seeking the Following Perspectives/Expertise:

We are seeking individuals with differing perspectives and areas of expertise, such as

• Cost measurement and methodology experts
  • Health economists, actuaries, researchers, or methodologists with experience in cost measurement, attribution, and risk adjustment
• Medicaid Program and data expertise
  • State Medicaid staff or researchers with expertise in Medicaid policy and program design
  • Experts in Medicaid data, analytics, and reporting, including experience with claims and encounter data (e.g., T-MSIS)
  • Individuals with experience in Medicaid performance measurement
• Managed care and healthcare delivery expertise
  • Managed care organization leaders
  • Healthcare delivery leaders overseeing behavioral health integration
• Operational and implementation stakeholders
  • BH practice administrators
  • IT and analytics vendors supporting Medicaid agencies, MCOs, and behavioral health practices
  • Quality measurement and improvement leads familiar with Medicaid and behavioral health initiatives
• Consumer/patient/caregiver
• Clinical and provider expertise (behavioral health and SUD focus)
  • Primary care providers
  • Behavioral health specialists, including psychiatrists, psychologists, addiction medicine
  • Nurses and care coordinators supporting integrated behavioral and physical health care
  • Social workers and community health workers addressing social needs and care navigation

TEP Expected Time Commitment: 

CORE anticipates holding two virtual meetings with a duration of approximately two hours each between March 2026 and September 2026, with the possibility of holding additional meetings after September 2026, if necessary. 

Next Steps:

To nominate yourself for the TEP: 

1. Please read the TEP Charter. You may access this document by selecting the title below:
   1. CORE Medicaid TCOC TEP Charter
2. Submit your complete Nomination Package (signed TEP Nomination Form, Letter of Interest, Curriculum Vitae [CV]) for the nominee by February 24, 2026. using one of the following methods.
   1. Web-based submission (preferred): Complete the online Nomination Form and upload your Letter of Interest and CV here.
   2. E-mail submission: Download a PDF copy of the TEP Nomination Form by clicking here. Then, fill out and sign the TEP Nomination Form and e-mail the complete Nomination Form, Letter of Interest, and CV to CMMIMedicaidTCOC@yale.edu.

To nominate another individual for the TEP:

1. Submit the nominee’s name and e-mail address using the web-based TEP Nomination Form here.
   1. If you are able to submit all information for the nominee (nominee information, signature, Letter of Interest, and CV) they will automatically receive an email informing them they have been nominated.
   2. If you are unable to submit all information for the nominee (nominee information, signature, Letter of Interest, and CV) they will automatically receive an email instructing them to upload or email the required information.
      1. Please ensure the nominee submits his/her complete Nomination Package (signed TEP Nomination Form, Letter of Interest, CV) by February 24, 2026. The nominee may submit her/her materials directly through the online Nomination Form or via e-mail (CMMIMedicaidTCOC@yale.edu) as noted above.

For any questions, please contact the measure inbox:  CMMIMedicaidTCOC@yale.edu 

Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures

Project Title: Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures

Dates: The Technical Expert Panel (TEP) nomination period opens on January 26, 2026 and closes on February 20, 2026. Submit all nomination materials by the closing date.

Project Overview:

The Centers for Medicare & Medicaid Services (CMS) contracted with Acumen, LLC, its non-profit partner firm The SPHERE Institute, and subcontractors (hereafter jointly referred to as “Acumen”) to develop outcome/efficiency measures. The contract name is Development, Reevaluation, and Implementation of Outpatient Outcome/Efficiency Measures. The contract number is 75FCMC18D0015, Task Order (TO) No. 75FCMC24F0146. As the organizer of this TEP, Acumen convenes groups of interested parties and experts who contribute direction and thoughtful input on their work and analysis.

Acumen is soliciting nominations for a TEP composed of interested parties and experts to contribute direction and thoughtful input to develop a new measure using administrative claims data to assess the Excess Days in Acute Care (EDAC) following an outpatient procedure or surgery for use in the Hospital Outpatient Quality Reporting (Hospital OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) programs.

Seeking the Following Perspectives/Expertise:

We are seeking individuals with differing perspectives and areas of expertise, such as:

• Clinician healthcare delivery perspectives reflecting the broad procedure types and surgeries that typically occur in outpatient settings, including hospital outpatient departments (HOPDs), Ambulatory Surgical Centers (ASCs), and Rural Emergency Hospitals (REHs)
• Clinician and provider payment policy
• Quality and cost measurement
• Pay-for-performance and quality improvement
• Research methodology, including risk adjustment
• Value-Based Purchasing
• Purchaser/insurer perspective
• Person and family perspective (i.e., patients, caregivers, and patient advocates)

TEP Expected Time Commitment:

TEP members will attend a virtual meeting in Spring 2026. The meeting is anticipated to be 2-4 hours, and include a follow-up poll for respondents to complete within the subsequent weeks afterwards. The objectives of the meeting are to gather input on the following topics: (i) the potential benefit and use of the measure, (ii) its specifications (i.e., denominator/cohort, numerator/outcome); and (iii) the risk adjustment methodology.

TEP meeting dates will be determined in consideration of factors such as the availability of TEP members and Acumen staff.

Below is a list of tasks expected of all TEP members:

• Review preparatory materials shared ahead of the meeting and complete any pre- or post-meeting survey, if applicable (estimated time between 1-2 hours)
• Attend and participate in the virtual meeting described above (estimated time between 2-4 hours)

Next Steps:

Please read the TEP Charter and complete the TEP Nomination Form. You may access these documents by selecting the title of each document:

• TEP Nomination Form
  • Interested nominees are required to submit a completed nomination form. As part of this form, nominees are required to upload: (i) a letter of interest (not to exceed 2 pages) highlighting experience/knowledge relevant to the expertise described above and involvement in measure development, and (ii) a current curriculum vitae (CV) or summary of relevant experience. If you wish to nominate yourself or other individuals for consideration, please complete the form by February 20, 2026 at 11:59 pm ET.
• Draft TEP Charter

Please email op-measures-tep-support@acumenllc.com if you would like to receive: (i) a 508-compliant version of the nomination form for submission via email instead of the web-based form, or (ii) additional information on the TEP nomination and measure development processes (or other information about the project generally).