In the CY 2026 OPPS/ASC Final Rule, the Centers for Medicare & Medicaid Services (CMS) formally finalized the removal of the Screening for Social Drivers of Health and Screen Positive Rate for Social Drivers measures from the Hospital Outpatient Quality Reporting (OQR), Rural Emergency Hospital Quality Reporting (REHQR), and Ambulatory Surgical Center Quality Reporting (ASCQR) programs.
Although this was not a surprise, based on the previous rulings, it is helpful to comb through the comments and responses to gain an understanding of why changes were made and what should be anticipated for future CMS changes related to quality reporting for health and wellbeing.
The decision follows a significant volume of public comments that reflected a wide diversity of perspectives on the value, burden, and future direction of SDoH measurements.
According to the final ruling, many commenters did support the removal of the two SDoH measures, emphasizing that the measures require substantial resources for data collection and manual processes. They argued that these activities divert staff from core patient-care activities and do not demonstrate whether facilities are actually addressing the underlying social risk factors identified during screening.
There was also mention of frustration with the duplication of the same screening questions across settings.
Many ambulatory surgery center (ASC) commenters emphasized that ASCs do not provide longitudinal care and often lack social work resources or community-specific knowledge for their patients. Some highlighted that staffing assumptions embedded within the measures, such as maintaining social workers, were unrealistic for ASC settings.
There was also a subset of commenters who understood the removal of these questions but reiterated their commitment to health equity work. These organizations reported positive outcomes in the collection that have already occurred, such as reduced readmissions and lower emergency department use when connecting patients to community-based resources. These providers emphasized they would continue SDoH screening voluntarily.
At the same time, many commenters opposed the removal of the SDoH measures, arguing these measures are in line with the CMS broader health goals and with the Make America Healthy Again initiative. Several urged CMS to either retain the measures or pause implementation to refine measure specifications, rather than a full removal. Others suggested voluntary reporting options to reduce burden while still supporting national data collection.
Commenters also encouraged CMS to use SDoH related ICD-10 Z codes for quality data reporting and consider how to align with external frameworks such as the NCQA HEDIS SNS-E measure, the HL7 Gravity Project, and USCDI standards. There were also recommendations for the development of future measures that assess the connections made to community resources rather than screening alone. The CMS response was telling that their focus is on reducing the cost of unnecessary reporting, while they evaluate alternative measures. However, it still appears that future measures have not been selected at this time.
At this time, the responses from CMS demonstrate an interest more in outcome driven metrics, rather than screening metrics. The agency is clearly signaling a broader, more predictive and holistic direction for future outpatient quality measurement. In the final rule, CMS specifically sought comments on the potential development of health and well-being measures, including tools that capture a person’s overall health, emotional state, social connectedness, sense of purpose, and life satisfaction.
CMS also requested feedback on the relevance and feasibility of tools that assess complementary and integrative health, self-care capability, and patient skill-building. Although commentators provided numerous evidence-based tools options for CMS, no final selection has been made for CY 2026.
Healthcare organizations should be prepared that a likely selection will be assessing patient preventative behaviors, nutritional outcomes, self-management capacity, and non-traditional supports (social connections) that contribute to long-term outcomes and cost containment.
