HQW 2026: CMS & the Broader Policy Landscape: What It Means for Quality & Safety (Live)-HQW 2026: CMS & the Broader Policy Landscape: What It Means for Quality & Safety (Live)

HQW 2026: CMS & the Broader Policy Landscape: What It Means for Quality & Safety (Live)

Video Transcription

Video Summary

Dr. Paul Keckley discusses how CMS shapes quality and safety in a highly complex U.S. healthcare system built on business-to-business relationships, not true consumer choice. He explains that healthcare is a massive, fragmented industry where most costs are passed through employers, governments, and insurers, while consumers directly pay less than 15% of total spending. Because the system is so decentralized, quality and safety are governed by many accrediting bodies, regulations, and thousands of metrics.<br /><br />Keckley emphasizes CMS’s enormous influence as both a payer and regulator, especially through Medicare and Medicaid, and notes the growing shift toward managed care, prior authorization scrutiny, and concerns about waste, fraud, abuse, and consolidation. He outlines five major trends affecting the industry: rapid clinical innovation, new technologies and interoperability, unstable regulation, capital market pressures, and rising consumer empowerment.<br /><br />He also highlights CMS’s current focus on behavioral health, social determinants of health, and the role of AI in clinical decision-making. Keckley argues that future quality and safety efforts must be more data-driven, transparent, and comparative. He closes by urging organizations to ask where the system is heading, how quality and safety will be defined in the future, and how professional groups like NACU can help shape that future.

Keywords

CMS

healthcare quality

patient safety

Medicare and Medicaid

managed care

prior authorization

behavioral health

social determinants of health