What Our President Told 1,500 Summit Guests About Quality

October 26, 2023 · Andy Reynolds

On October 23, 2023, NCQA President Peggy O’Kane welcomed 1,500 quality advocates from 50 states, Puerto Rico, Denmark, Canada and India to Orlando, Florida, for NCQA’s largest event ever, the Health Innovation Summit 2023.

Read her opening remarks to know where NCQA is headed:

Thank you all for being here. We are so excited.

When we started NCQA 33 years ago, we could only dream of a gathering like this—so many people who actually get the job done to improve quality, together in one place.

This is an opportunity to learn from each other. We learn from you, and our speakers learn from each other.

It’s also a time to support each other. Because the work we do is challenging—technically challenging. And, you know, we’re living in a pretty crazy time. So we need all the help we can bring each other.

I’d like to frame for you the priorities we’ll be talking about and that you’ll be hearing about at this event.

And I’d like to tell you what I hope you’ll get from our time together over these next two and a half days.

There are also three new developments that I get to announce.

***

A lot has happened since I spoke to you at the first Health Innovation Summit a year ago.

In February, CMS announced the Universal Foundation Aligning Quality Measures. We congratulate them for their leadership in acting on the idea that aligning measures is one of the best ways to put some punch behind quality measurement.

When things are measured differently at the practitioner level, the delivery system level and the plan level—the differences can be annoying and unmotivating for practitioners, and also confusing. We kind of squander our signal, that way.

So: alignment: Remember that idea. I’m going to come back to that.

Reducing Measurement Burden

Digital quality measurement has made big strides in the last year.

It’s fair to say that NCQA has become obsessed with digital measurement and the potential that digitally enabled care offers our health care system.

There are many reasons we’re determined to build a digital future. Let me highlight three.

First, and most important, digital measurement is key to reducing the burden of measurement on providers and practitioners.

Reducing burden is the quality community doing our part to relieve a health care work force that’s more strained and demoralized than I’ve ever seen.

We want measurement to flow from the day-to-day delivery of care.

Quality shouldn’t be a separate process or second job that practitioners have to do on top of their duties taking care of patients.

In a digital world, measurement will happen automatically, as a byproduct of care.

When measurement becomes less of a burden on providers, they can focus on their patients and get some time back for themselves.

Another great thing about digital measurement is it can tee up the right thing to happen, at the right time—at the point of care. So, getting it done right the first time.

When data flows freely, providers get timely, relevant feedback or signals they can use in the exam room, and in digital interactions with patients.

Third, a digital measurement ecosystem can help us shift the paradigm of what quality is all about.

Going digital can help us make quality less of a contest, and more about lifting the performance of the whole system.

Obstacles are everywhere in our quest to digitalize quality. It’s complex work, full of wicked problems.

But there is transformational potential and the transformation of care itself is something that I think we’re beginning to see glimmers of. We can only imagine what that’s going to be like in the future.

Alignment, Alignment, Alignment

So, let’s talk about alignment.

People ask, “What will it take to cut through these problems?”

I come back to one thing: alignment.

Lack of alignment is the main barrier to better measurement and to sharing data more efficiently.

People who care about quality have to come together and agree on data standards and core principles that work for everyone.

NCQA can’t do this alone!

If we’re going to make the most of digital measurement, NCQA needs to go beyond ourselves to get on the same page with many allies who are also working for better care.

We’ve been feeling that support and collaboration, and I especially want to mention CMS and the Office of the National Coordinator for Health Information Technology.

We have a number of top officials from CMS speaking at the Summit. I’m looking forward to those sessions and urge you to attend.

Digital Quality Implementers Community

Speaking of partners, here are some announcements we’re going to make at this conference. But I’m giving you a sneak preview.

We have a Digital Implementers Community. This is a group organized by NCQA and Leavitt Partners. And we’re out there talking to others who are playing an important, foundational role in the digital measurement ecosystem.

And in this room, on Wednesday, we will watch this new collaboration that will help us reach the digital future.

It’s a group of public and private leaders, building tools and platforms that make digital measurement possible. Again, that’s right here, Wednesday.

HEDIS, Digitalized!

It’s also my pleasure to announce that we’ve reached an important milestone in our journey toward a world of digital measurement:

NCQA has just digitalized 77 HEDIS measures!

That means we’ve rewritten 77 of our measures as software code.

Because of that, you can produce scores from digital HEDIS without needing to program the measures yourself.

Digitalizing HEDIS is a big step toward creating a world of efficient and effective digital measurement. But it’s far from the final step.

What we’re trying to accomplish with digital measurement is the most ambitious project in our 33 years. We’re getting closer to our shorter-term goals every day.

You still can’t use digital HEDIS for reporting because there’s a lot of benchmarking and so forth that we have to understand first. But you can use it for quality improvement.

We also have a group of early adopters. We have, I believe, five now, several more in the pipeline, and we’re going to be accepting more applicants for early adopter status.

The early adopters will help us work through things, as the digital system is different in each organization. We have to understand that variety if we’re going to do our job right.

Centering Health Equity

There’s another priority, right alongside digital measurement, that we’ve been putting a lot of energy into and that we think is vital to our country’s future: health equity.

There can be no quality without equity.

NCQA has committed to integrating health equity into all our measures and programs.

Health equity has become the water we swim in, and something that permeates everything we want to achieve.

This conference reflects that commitment: More than 20% of sessions focus on health equity.

I am impressed by the leadership of state Medicaid officials on health equity. They are some of the most dedicated and effective people working to advance quality.

They helped us learn about health equity, and now we’re helping them:

14 states—including California—mandate NCQA Health Equity Accreditation for Medicaid health plans in their state.

That means almost 30 million Medicaid enrollees are in a plan that NCQA Health Equity Accreditation helps hold accountable.

It’s gratifying to see so many state leaders stepping up to make care better for people who’ve been left out or left behind.

Like digital transformation, equity cannot be achieved alone. It requires alignment (again) and collective action.

NCQA is helping make health care more equitable by building a foundation of evidence, identifying best practices and creating new measurement strategies.

In the last year, we’ve released new tools and reports to help improve data collection critical to health equity.

We’ve made HEDIS measures more gender-inclusive and expanded race and ethnicity stratification, so we can analyze more carefully where and why care gaps exist.

Now we’re building partnerships with community organizations, looking at how health plans can help address climate change and building ways to score equity as a dimension of quality.

New Work with CMS’s Office of Minority Health

And now for the third piece of news I get to share with you today:

The CMS Office of Minority Health has awarded NCQA a major contract, called the Health Equity Accelerator.

This multi-year program addresses health and health care disparities affecting underserved populations.

We are honored to continue our productive relationship with the Office of Minority Health.

We also look forward to partnering with RAND and Rainmakers Health on this gratifying and important work.

Summit Takeaways

That brings me to you, and what I hope you take away from the Summit.

It comes down to the words beside me on the stage: Inspire and Connect.

We convened this conference so you can learn from each other and from the speakers. Because we all need new ideas. We’re doing things that haven’t been done before. We need to learn from each other to make things happen in an appropriate timeframe.

And there’s one thing I know: If you work in quality, your job is HARD.

Quality is hard.

Reinventing health care is hard.

Turning around decades of analog thinking and inequities in health care seems impossible some days.

When you go home on Wednesday, I hope you’re brimming with new ideas and energized in the knowledge that you’ve got a hard job, but you’re not alone.

There’s a whole community of people working for the same things as you. Together, we can get where we all want to go.

Thank you again for being here. Let’s have a great conference!