Why one new quality measure signals a much larger shift in healthcare.
"Healthcare changes when what we choose to measure begins to reflect what patients actually experience."
One of the more meaningful developments in healthcare this month wasn't the approval of a new technology or the publication of a landmark clinical trial. It arrived quietly, in the form of a new quality measure from the National Committee for Quality Assurance (NCQA).
Beginning with Measurement Year 2027, health plans will be asked to report whether patients who receive an abnormal stool-based colorectal cancer screening test go on to complete a follow-up colonoscopy within 180 days. On its surface, the announcement appears administrative, a new HEDIS measure added to an already extensive list of quality metrics. It would be easy to read it as another reporting requirement, important perhaps to health plans and quality teams, but unlikely to capture much broader attention.
I suspect it deserves far more attention than that. Quality measures have always done more than evaluate healthcare. Over time, they influence the behaviors, investments, and priorities of the organizations they measure. They shape conversations in boardrooms, guide operational improvements, and quietly redefine what success looks like. In that sense, every new quality measure tells us something about what healthcare has decided is important.
This one tells us something particularly interesting. For years, colorectal cancer screening has largely been evaluated by participation. Did eligible patients complete screening? Did health systems increase screening rates? Did more people gain access to testing? Those questions remain critically important, especially when millions of Americans remain unscreened.
But this new measure asks a different question. It asks what happened after the screening. That may seem like a subtle distinction. I don't believe it is.
From a test to a journey
Patients have never experienced healthcare as a series of disconnected quality measures. They experience it as a continuous journey, one that begins with a concern, moves through testing, diagnosis, treatment, and, hopefully, resolution. Every transition matters because every transition creates an opportunity for confusion, delay, or loss to follow-up.
Healthcare, however, has often measured these moments independently. Screening belonged to one metric. Follow-up belonged to another process. Outcomes were evaluated somewhere further downstream. The patient experienced one continuous story while the system observed it as a collection of individual events. The new NCQA measure begins to narrow that gap.
By holding health plans accountable for whether patients complete a diagnostic colonoscopy after an abnormal stool-based screening result, the measure acknowledges something clinicians have understood for years: screening is only valuable if it leads to an answer. A positive stool test is not a diagnosis. It is an indication that more needs to happen. Until that journey reaches diagnostic resolution, the promise of screening remains incomplete.
That idea has been gaining momentum across the colorectal cancer community. Organizations like Fight Colorectal Cancer, through initiatives such as the Colorectal Cancer Care Initiative (CRCCI), have argued that accountability must extend beyond participation and into timely follow-up. The new NCQA measure does not yet achieve all of those ambitions, since it currently applies only to stool-based screening and allows a follow-up window longer than many clinical leaders would prefer, but it represents something very powerful. Meaningful progress toward measuring what patients actually experience.
A Question Worth Asking
If healthcare quality is ultimately judged by patient outcomes, should our quality measures continue evaluating isolated moments or should they begin measuring complete journeys?
About the Author:
Tom Sanders is CEO and co-founder of Aton Health. Through this ongoing essay series, he explores the systems, operational realities, and clinical pathways that determine how healthcare innovation becomes better patient care.