Right. So we will give everybody about a minute or so to get settled in. Welcome, everyone. Good afternoon. Again, just wanna give about one minute or so for everyone to get settled in. Thank you. All right. So we are at one zero one on the dot, so we are gonna go ahead and, get started. So good afternoon, everyone, and thank you so much for joining today's webinar, Shaping the Future of Insights from the Advanced Primary Care Pilot. We truly appreciate you for taking the time to be with us today, and we're so excited to share insights from this important work. My name is Amy Awate, and I'm an assistant director of recognition programs here at NCQA where I comanage this pilot with my colleague. So I will be one of your hosts for today's discussion, and I am joined by my colleague, Jeff Sitko, who has played a key role in shaping the direction of this work. So I'll hand it over to Jeff just to briefly say hello and introduce himself. Hello, everyone. Thank you so much for joining us today. Jeff Sitko, assistant vice president of product management here at NCQA. I oversee our Care Delivery Program portfolio. You're familiar with PCMH. We are so excited to talk with you about advanced primary care today. I've been working with our pilot participants in reviewing our standards, our measures, how all of this work really aligns with what matters to them and to their patients. So very excited for the conversation with you all today. And Amy, I will pass it back to you. Thanks, Jeff. All right. So before we get started, I want to briefly ground us in the purpose and journey of the advanced primary care pilot, or APC pilot as you'll hear us refer to it today. After about a year of research and development, APC has finally moved into the pilot phase, which was conducted in January through June twenty twenty six. The goal of the pilot was to explore how we can evolve our programs to better support high performing primary care delivery organizations while ensuring that our APC standards truly reflect what's happening in the real world, in the care delivery environment today. The pilot was structured in two phases. In phase one, we focused on learning and collaboration where we worked closely with participants to review and refine the standards through discussions and working sessions. In phase two, we moved into testing where organizations applied the standards and submitted evidence, for us to review and assess so that we could assess feasibility of the standards requirements. We then use those insights and feedback to strengthen the model and ensure that it's both practical and scalable across the range of collect care delivery organizations represented by our pilot participants. And speaking of pilot participants, we are especially excited to be joined by the organizations that participated in our pilot program. Their partnership and feedback have been so critical in helping us evolve this work. Today, you'll hear directly from them about their experiences, key insights, and perspectives on what this means for the future of primary care. So I would like us to quickly cover a few housekeeping items as you can see on your screen. At any time during the webinar today, please, we encourage you to submit questions using the q and a function on your screen. Again, I encourage you to continue submitting questions throughout the entire session, and we will respond post webinar. So what does this mean? We'll be compiling all the questions at the end of the webinar, including responses, and we'll follow-up by sharing them with all pilot participants. We have also received a presubmitted question that we'll address later on in this session. So let's get started. We would love to get a sense of who is on our call today. So I'm gonna go ahead and launch the polling, and the polling should be on your screen at this time. Our first question is what best describes your organization? Are you an integrated health system, a hospital, independent primary care practice? Are you a health plan? Are you an ACO? If your organization is not listed, please please share in the q and a box what your organization type is if it's not listed. So we'll leave it up for about thirty seconds or so, and we'll go to the next question, which I've already seen folks starting to fill in question number two. Is your organization currently NCQA accredited, recognized, or certified? Yes or no. And if yes, in what programs? We have a wide array of programs that we offer here at NCQA, so we have included a shortlist of our programs. So if a program is not listed, please share in the q and a box which programs your organization is accredited, recognized, or certified in. Or if you're a PCMH CCE, there's an option there as well. We would love to recognize the PCMH CCEs representing on the call today. So it looks like about forty seven percent have participated. I see things slowing down a little bit. Just taking a look at the results. I'm gonna go ahead and end the poll. Alright. I will go ahead and share the results as well. We have about thirty percent of integrated health systems joining us today, thirteen percent of hospitals, nine percent of independent primary care practices, seventeen percent of health plans, and thirty two percent of others. And if you look in the q and a box, you'll be able to see the others that are not fully represented on the polling. Is your organization currently accredited, recognized, or certified? Sixty six percent said yes. Twenty three percent said no. Eleven percent are unsure. But if you did answer yes, it looks like, two percent are accredited in case management, two percent are community focused care accreditation, two percent are in credentialing accreditation or certification, two percent diabetes, DRP, four percent health outcomes, fifteen percent health care health plan accreditation. We have thirteen percent of CCEs recognized today, forty three percent of PCMH recognition, and, thirteen percent other are not listed. So thank you all for participating in our in our polling today. Now that we have a better understanding of who's on the call, I'll briefly walk through the the agenda. So we'll start with introductions from our panelists, then we'll move into a discussion with our pilot participants, cover the presubmitted question, and close with information on public comments and next steps. Alright. Let's go to the next slide. We briefly introduced ourselves at the beginning, but for those who might have just joined, I am one of your cohosts, Amy Awate. I'm an assistant director with our recognition unit recognition programs unit. I've been with NCQA for about eleven years. But in my current role, I help lead the operational strategy and implementation across our recognition and accreditation programs, some that you are familiar with, including, but not limited to, patient centered medical homes, which is our PCMH recognition, virtual care delivery accreditation, and etcetera. For the APC pilot specifically, I have the opportunity to work closely with with our internal teams, external surveyors, and our pilot participants to operationalize the APC model. This included overseeing how the pilot was executed day to day, working directly with organizations as they applied the standards internally, and our surveyors who reviewed evidence, just, you know, ensuring that we were capturing meaningful insights throughout each phase of the pilot. So today, I am joined by my colleague, Jeff, who introduced himself earlier as my cohost, who will introduce himself again, and I'll also turn it over to him to introduce our panelists. Thank you so much, Amy, and I will be judiciously brief. Again, Jeff Sitko, AVP of Product Management here at NCQA overseeing our care delivery programs. I have been at NCQA a little under two years, and prior to coming here spent most of my career in leadership roles on the delivery system side, health plan side, consulting, all in practice transformation and value based payment and contracting. Been an NCQA fanboy my entire career, so I'm very, very honored and privileged to be overseeing our work for advanced primary care and very deeply fortunate to be working with our pilot participants. Now having said that, before I pass it to each of our pilot participants and panelists to introduce themselves, tell you a little bit about who they are and their organizations, I want to just first very, very sincerely thank them. Alladay, Jefferson Health, Bluegrass Community Health Center, and New York City Health and Hospitals. Each one of them, I can tell you, brought a unique, deeply, deeply important perspective to the work that we've been doing in the advanced primary care pilot. So I know I can speak on behalf of the entire NCQA team when I say that we appreciate their engagement more than I can possibly articulate. They have been endlessly patient with me asking what about this, what about that, does this match reality for you? Would this be helpful? What's not? So thank you to each one of them for taking the consistent time to help to sculpt a program that aims to really drive actual value for primary care and for primary care's key partners and patients. Now, on to more interesting people for you to hear from today. Not that Amy isn't deeply interesting as well, but you're really here to hear from our pilot participants. I'm going to pass it to our esteemed panelists to introduce themselves. And as part of your introductions, if you could also just each please tell us why did your organization decide to participate in the pilot for advanced primary care, and what were you hoping to get out of it? So let's start with Noelle at Aledade. Noelle? Hey, everyone. My name is Noelle Dear. Like Jeff mentioned, I am representing Aledade today. As many of you may know or may not, Aledade is a national, care enablement company. We have many ACOs across, the US. We partner with over three thousand independent primary care practices to deliver, VVC to our patients, whether that's through an MSSP ACO or through one of our many payer contracts. Last year, we hit a major threshold of saving over a billion dollars in shared savings with CMS. So, you know, we are huge supporters of the work that NCQA is doing and, really truly believe in the value of value based care. The reason why we joined the pilot was because we really want to highlight the work that aggregators are doing in this space. We work with many independent primary care practices who may not have the ability or opportunity to, you know, gain that NCQA accreditation. And through the work that they do with us, we wanna help highlight, all the great work that they do in their clinics. And so we believe APC is a way for us to help our practices, get their voices heard and elevate the work that they do day to day. Thank you so much, Noelle. And now let's go to doctor Flatow at Jefferson Health. Hi. I'm Anna Flatow. I'm the chair of Family and Community Medicine at Thomas Jefferson University and the system chief, for, Jefferson Primary Care, which is part of a regional health system in eastern Pennsylvania and southern New Jersey. You can see on the slide, as a larger organization, we have a university, a health system, and a health plan. Our, health system is obviously our largest, part. We have a thirty three, hospital, system, with over four thousand physicians. And I if you'll turn to the next slide, of our seven hundred, ambulatory sites, about one hundred and fifty of those, are primary care practices. So we care for about a million patients, through those sites as well as the virtual and home based programs. And that is the majority of the patients who are being cared for in our hospitals, as well as the majority of the patients who are being cared for in our specialist settings as well. So as you can see from the border, a selection of a lot of variable communities and different types of practices that we bring together in a single system. And we were really excited to participate in this pilot program because we, like all health systems and other health care entities, spend a lot of time navigating an environment where it's important to talk about what quality is and what good care is. And this was an opportunity for us not just to navigate, but to help shape that discourse by providing real on the ground feedback from our teams who do this work all the time clinically, operationally and in data analytics to provide feedback and be heard as to how these this type of model can both help us to advance our care in the direction that it should go in in primary care and also be a feasible partnership for our teams. Fantastic. Thank you so much, Doctor. Flatow. And I recognize we jumped over some slides for our participant at Bluegrass Community Health Center. I got the order a little bit out of sequence there. Brandy, if you could tell us a little bit about the work that you do at Bluegrass. Sure. Thanks. So my name is Brandy Coyle. I am the chief compliance officer of Bluegrass Community Health Center. I've been with the clinic for about thirteen years, and, we are a federally qualified health center in located in Central Kentucky. We work with many of the medically underserved members of our community. We see approximately eleven thousand patients per year, most of which have some significant challenges related to accessing health care. For instance, more than fifty percent of our patients don't speak English, and ninety nine percent of our patients are, at or below two hundred percent of the federal poverty level, with eighty five percent being at a hundred percent or below. And in addition to those financial limitations that our patients have, many of them are are also uninsured. Those that are, you can see about thirty seven percent of our patients are covered by Medicaid. So you can go to the next slide. We do serve an eight county service area in Central Kentucky with, four of our locations being fixed locations. But those, sites are supplemented by, mobile service units and, also some outreach that we provide where we'll take a a team to a farm and and set up a clinic so that farm workers can get care there. Our care centers around, medical, primary care, throughout the lifespan of the patient, behavioral health and site care, as well as substance use treatment. Go to the next slide. But we do have significant history with NCQA. BCHC was initially received patient centered medical home recognition from NCQA in twenty thirteen, and we are proud to be, one of the first Kentucky based well, actually, the first Kentucky based health center that was recognized. And, in twenty twenty, we, achieved a distinction in behavioral health integration. And since then, all of our sites have become patient centered medical home sites. And we we really feel that that quality and evidence based practices are important pieces of the care we provide. And so when we heard about this new potential model, we were super excited to get the opportunity as such a small organization to get to participate in this great new program that they're creating. We feel like the advanced primary care model really seems to recognize the depth of the work that we are doing without being overly burdensome. You know, we were a lot of the work we did already for our our PCMH recognition translated here well. Anyway, we we were really excited, and and we think this is a great opportunity for others. Thank you so much, Brandy. And now I will pass to the team at New York City Health and Hospitals, Cherilyn, Thomasina, Grace. Thank you very much. Thank you, Jeff and team. It's been so exciting to work with you. And I just wanna let everyone know a little bit about our team. My name is Cherilyn Ray, and I am the senior clinical nurse practice adviser. I work in what we what we call central office. We are the central office team for PCMH, along with my colleagues, Thomasine Barnes, who is the director of PCMH, and Grace Scarf, who is the assistant director of PCMH. As a team, we work to, support the entire New York City Health and Hospitals system in providing the highest level of care throughout PCMH accreditation. And, also, we support our federally qualified health centers, Gotham, and their team in also achieving the same high standards. A little bit about New York City health and hospitals. We serve over a million New Yorkers. We, through eleven acute care hospital sites, twenty nine community health centers, five level one trauma centers. We also have long term acute hospital centers and post acute facilities, Also, correctional health facilities, are under our purview. We have a workforce of about seventy thousand members that participate in the care that is rendered to our patients throughout our systems, and send seventy percent of our discharges are patients covered by Medicaid or our essential plan, which is a plan that covers New Yorkers that don't have Medicaid, don't qualify for Medicaid, or any other insurance. Next slide, please. So a little bit, about our background will be, shared with you by Grace Scarf. Thomasina, go ahead. Background. Thomasina. Sorry. Thomasina Barnes here. So just to piggyback off of what Cherilyn said regarding our partnership with NCQA. So we first pursued PCMH back in twenty ten, so kinda since the inception of PCMH. So we've been doing it all those years. There have been forty three sites in total to gain PCMH recognition. And out of those sites, twenty six are currently recognized under New York State PCMH, eleven are the acute hospital sites, and currently there are fifteen Gotham FQHC health sites. And also, we have just recently been designated with the diabetes recognition program for a lot of our sites. So next slide. Hi. This is Grace. Just to quickly go over what we do in addition to what Cherilyn had mentioned, we work with, you know, all of our hospital eleven hospital sites in addition to collaborating with the other departments throughout the system, including our managed care, VBP teams, our quality and patient experience teams, as well as the EPIC, which is the EMR we use EPIC team. And we are in the department of clinical services and population health. And within this department, we also work closely with chronic disease and collaborative care teams on PCMH. Next slide. I think that's it. And we just question. Sorry. Yeah. Go ahead. Go ahead. Answer the question about or start to answer the question, we'll each chime in about why our organization decided to participate in APC. Given that all eleven of our acute hospital sites have been recognized by PCMH from the beginning and have sustained their recognition, we believe that we were ready to take primary care to the next level, and of course, that being advanced primary care. We also felt that participating in the pilot would give us a platform to showcase what has been implemented at H and H and our successes across various initiatives at the scale of the largest as the the scale of the fact that we are the largest public health system in the country. And last but not least, we wanted to take advantage of this opportunity to inform and help form the expectations of these APC standards that will become the backbone of the program. Fantastic. Thank you all so much. Thank all of our pilot participants. Fantastic overviews. And thank you again for joining us today. I am so excited for our audience to hear more from you today. You're such rock stars in this arena. But enough of me blabbing on and on. Amy, I will turn it over to you to get us started on some questions with our panel. Yeah. Thank you so much, Jeff, and thank you, to all of our panelists for those introductions. Alright. So we are going to, start with our individual questions, and the first question will be directed to, Bluegrass. So, Bluegrass, how did having PCMH recognition help you to navigate the primary care pilot? And as an FQHC, were there other ways your existing structure supported your organ your participation through the pilot? So, I would say that I think, already having the patient centered medical home recognition was it was helpful in that, we were familiar with NCQA expectations of quality and what they like to see. So that translated well here. A lot of the evidence as far as documented processes and and things that we'd already put in place as a patient centered medical home translated well here, and and we were able to use a lot of that similar evidence for for the APC program. I will say that I felt like it was different and that they seem to be more focused on us really showing evidence of implementation. So and seeing that in in what we were submitting as as evidence. And and I think that was somewhat different, but I did appreciate it because I felt like it gave us an opportunity, and we give organizations of all sizes, both both large systems and smaller ones like ours, to highlight our unique strengths and and approaches. I would say also say as as an FQHC, we are we do have some set standards and requirements as a for our quality program and our our risk management programs that overlapped well here. And so it didn't feel like it was adding a lot of unnecessary extra work to what we're already doing. Thank you for responding to that. Yeah. I was, going to follow-up to ask about any unique advantages or any challenges that you would highlight. You covered it in your responses, but, feel free to share any others. Well, I do I wish, we we are we have a staff of about a hundred employees. And so the group that worked on this was, myself and two quality analysts who honestly pulled a lot of the groundwork for us. But I really wish that I had involved our operations team more so that they could, you know, give their insights and suggestions as well. But oops. But, anyway, with we were you know, I'm glad that we did we're able to participate, and, you know, we can do that when we go for the full recognition. Absolutely. Well, thank you so much, Brandy. I will turn the next question over to NYC Health and Hospitals. Alright. So my question yes. So my question for you is, what capabilities within your organization proved most important in enabling you to advance primary care consistently at that scale? Thank you. One of the things that we found was that our data analytics capabilities have grown tremendously over the years, and this includes robust homegrown dashboards for population health and and just many different aspects of the care that we render to our patient. And these house key metrics in population health management, access and continuity of care, care coordination, various health drivers, including SDOH, insurance status, race and ethnicity, and the utilization of inpatient and ED visits. The dashboard allows our users to track, trend, and act on data, which is critical to improving patient care. So these things helped us to constantly increase our efforts and to scale, the work that we do. In addition to that, just to, you know, add that, also, we have a very close relationship between our primary care teams and the rest of ambulatory care, including ED and as well as in the ED and inpatient teams due to our share EMR across the entire system. So we're able to kinda have that seamless flow of information as we deliver care to our patients. And we have also established very tight knit working groups pulling from multiple disciplines and teams, which allows us to develop data driven strategies and workflows that are then successfully implemented on the ground within our clinics. And this, you can actually see in our primary care practices and delivering care to our patients. And in addition to that, due to the size and complexity of health and hospitals, we have a lot of variability as different sites provide care to different populations within New York City. So as such, it's not always feasible to have fully standardized processes and workflows across all of health and hospitals. But this variability is actually one of our strengths as it allows health and hospitals as an organization to address the diverse medical and social needs of our patient population through site specific PI projects to improve clinical and quality metrics or process outcomes. So, for example, referral tracking, post discharge follow-up, and then we share our best practices across the system so that any of our sites may be able to learn from each other and then implement any of those best practices at their sites. You for your responses. Yeah. I remember from the pilot, one of the compliments that were given from our surveyors was the your reporting tools. So would you would you say that, you know, the reporting tools and and the collaboration between, you know, your your hospitals, made the biggest difference for you? Yes. I you know, when I first started working here thirteen years ago, there was a lot of silo. And I think these reporting tools really, you know, lifted those walls and allowed us to communicate and then have more standardization. But standardization from best practices and from honest data as opposed to, you know, homegrown data or homegrown practices. It really became more evidence based, and so sharing that information allowed us to, you know, improve the outcomes for our patients. But I think also very importantly, we've learned through this process of the pilot that, we have a lot of subject matter experts, and we need to include them, when from from the inception when we start to do things like this because that was one of the, hurdles that we had to to climb in order to, you know, really learn about what these systems are and how they work better or best. Thomasine or Grace, I don't know if you wanted to add anything to that. I think you summed it up. Yep. And and, Cherilyn, I think that's a key point that that all of our pilot participants would echo if they have the opportunity. So thanks for pointing that out. Cross collaboration, getting SMEs involved very early on is is also key. So thank you, York City Health and Hospitals, for your responses. I'll turn it over to Jeff. Thank you so much, Amy. And my first question here is going to be to doctor Flatow at Jefferson. Doctor. Flatow, Jefferson is, I think it's fair to say, such a thought leader in primary care. The work that you are doing, it's innovative, it's grounded, it's deeply patient centered. Let's talk a little bit about how Jefferson thinks about measuring success in primary care. How can that happen, do you think, in a way that really reflects the realities of a model that's relationship based, it's team based, without adding a whole other layer of burden that pulls people out of the work itself? You know, I appreciate that question. It's a complicated question, but it's such an important one and in some ways, the central question around primary care quality that probably everyone on this call and in the audience, you know, work struggles with or works with day to day. How we measure success is so important because if we pursue success, but we've defined our success in the wrong way, we may succeed at the wrong thing. Right? So we we really wanna center on what is the value of primary care, which is well defined. Right? It's relationship based, it's comprehensive, it's longitudinal, it's first point of contact, and that is important to itself measure. There is always a tension, right, between those sort of larger measures that matter and also the more disease specific or preventive area specific metrics, which we all know there there are hundreds of potential metrics, you know, in that in that bucket as well as underlying process metrics. So how does one make a package, right, that is actually meaningful and that drives toward what matters to patients and what matters to communities and what we all went into health care in order to deliver? So I think there's there's a couple pieces to that. Right? And I think the NCQA process was thoughtful about this. Right? We do need to measure specific areas of success. And also, we want to think about underlying core processes and approaches that deliver for communities. When I think about the specific metrics, they need to focus on things that we clearly matter. Right? I'm going to take an example like hypertension. Right? We can all agree hypertension, the control matters. These metrics also, though, help to direct attention and resources and focus in building systems that deliver well for patients who have chronic disease in general. Right? So the work that we might do in an organization to ensure that we improve our hypertension control rates also teach us, right, about team based care. They teach us about registry development. They teach us about patient engagement. They teach us about how we think about equity. They teach us about many different things and help to further advance fundamentally how we function as a primary care system and as a a larger health system or larger entity overall. So those metrics in some ways are like the canary in the coal mine if they're not working well, but they're also a an engine, right, to building out some of our core processes that we need in order to be successful as an advanced primary care system. And I think that's true for many of the other metrics that were brought forward by NCQA and vigorously vetted right by these four very diverse organizations to make sure that they speak to what matters to us and what what matters to us because it matters to our patients and to our communities. So I appreciate that very much. In terms of the speaking to something that's not burdensome to to to produce, we all are fans of existing data. Right? And we've all suffered the eras of, like, the checks boxes in the EMR. I think, hopefully, we're beyond that. Right? So I think this process did a good job in vetting not just with clinical leaders and operational leaders, but with the people who actually have to get the data. Right? I mean, in order for these types of things to happen, is this doable for you? And we we literally ranked, like, high, medium, or low. Do you think you're gonna be able to do this, and how confident are you? And I think that was a very useful process because, that's not even my assessment. Right? That's our analysts and our on the ground, you know, quality, improvement staff who have to do that work. And, I think it was nice to see how that landed on things where we either had very high confidence or if we didn't, we recognized internally that we probably should fix it internally. It wasn't a problem with the magic. It was a problem with us, you know, needing in those few areas to to put that in place. And so I really appreciated that, aspect of this as well. So it has to be existing data or, like, very simple very simple, you know, screenshot, very simple ways of documenting processes that do not create a mini internal industry of doing the work, but in fact, are efficient, speak to work that is meaningful and reflect what we're already doing and how that's embedded in our electronic medical records and our in our data systems. And that way we can reduce the opportunity cost and reduce the actual cost of doing the work of reporting the metrics while also ensuring that the metrics, which are the language that we use, right, metrics are language. It's language that we use that creates communal language between the people doing the care, the health system leader, NCQA, health plans, a single unified language that we can all agree on. It's not gonna be perfect. Right? But it's gonna be good so that we can talk together about what quality really means and and advance that care together. Anna, that was absolutely fantastic. You you hit on so many really important points there. I I think the one that high quality care is ultimately community driven care. I like the framing in terms of attention, resourcing, and focus. And that being, I think, a key barometer for us, how do we make sure that primary care is getting what it needs to succeed, not just that we're creating a set of standards and guidelines in terms of the actual attention economy about setting primary care up for success. And I love the way that you phrased metrics as language. If we are talking about a definition of success and how we're actually helping individuals and populations, it makes sense that we're all aligned on terms that we can agree on. So I absolutely, absolutely love that framing. Excellent points. And I also have a question for our friend at Alidade. Noel, if I can just ask you, Noel, you have a very, very unique vantage in terms of Alidade's, I'll say, very, very important role in supporting independent practices as a high functioning care enabler. So how do you see the advanced primary care model? I mean, you've really been in this work deeply rolling up your sleeves as we've been sculpting the criteria. How do you see this model helping the practices that Alidade works with? How do you see it helping the payers that you partner with, other stakeholders? Really along the lines of what Anna was just mentioning about metrics as language, everyone kind of getting more aligned around priorities and expectations for success and value based care. Yeah. For sure, Jeff. And first, I just wanna shout out you and the NCQA team. We've been in the trenches since July twenty twenty five, it feels like. We've been having these conversations, and so it's just amazing to see, the fruit of your labor finally coming forward, and we're finally here. And so to your question, though, I think NCQA is uniquely positioned to highlight and validate all of the work that is happening across these organizations. Through the accreditation, there's an opportunity to really show the industry where practices, whether it's independent, system led, where they're actually delivering on improved quality and, changing total cost of care. And I think that having that NCQA validation will go a long way for many of those in the industry who know that we're delivering value, but we really wanna be able to champion it. I think that payers will benefit from understanding who is actually doing the work, and I think there are multiple subset of payers. And a couple that I'm gonna, you know, really focus on are those payers who or purchasers. So I think sometimes some employers might be in this space as well, particularly those who are self insured, who really want to get in the action of VBC. And they hear all these buzzwords at industry conferences, conferences, but don't really understand or know how to even find the right group of practices or even understand who's actually doing the work. And I think that an accreditation from the NCQA will help those, purchasers understand who can actually help them, you know, impact positively impact their total cost of care while improving, quality. And so I think that if you are someone who is not really in the BBC space or is still has those maturing capabilities because as much as there is a lot of capabilities on our side to really, you know, understand the data and the reporting, payers also have to invest in those capabilities as well. And so if there's a way where NCQA can say, hey. We already have the metrics. You don't need to actually create your own metrics. We have a standardized metrics that we know that work and that we have outcomes that are actually proven against these metrics, I think that you could really increase the adoption of VVC across a very different set of, payers and purchasers than you have today. Fantastic. Thank you so much, Noel. Excellent excellent points. And I I love the framing in terms of the the actual demonstrable value from a a payer perspective in terms of value based care and progression. We had a a state webinar yesterday where we talked a little bit about the fact that primary care is doing the hard, often unglamorous work to make sure that people are able to really live within a definition of wellness for them as individuals. And I love the way that you phrase that in terms of the impact to total cost of care. Right? Because from a payer standpoint, that's where you see that really bear out, the impact that primary care can really materially drive. So wellness translated in terms of back to that line about metrics as language, Anna in terms of the actual metrics themselves. I I think that that's an excellent point, Noelle. Appreciate all the insights and appreciate all of our pilot participants and the hard work that you have been doing throughout this process. As Noelle said, it has stretched back several months, so thank you for helping us to get to this point. And I think with that, we can probably go to the next slide, and I can explain for our audience a little bit about our overview for Advanced Primary Care accreditation. So what are we actually talking about here? Right? As we're moving into the public comment process now, I want to thank you all at home or the office, the coffee shop. I'm not prejudging where anyone is joining us from. Wherever you're from today. Thank you so much for riding along with us through this great conversation with our pilot participants. I do want to take a few minutes just to walk you through this model. So at the very highest level, this program is designed to define, as you heard from our panel today, advance and advance high quality coordinated primary care in today's very rapidly evolving environment. So whether we're talking about payment models, the available technology, what patient expectations are, everything is shifting very, very fast underneath the feet of primary care. So the question we've been asking ourselves is, how can we build this to align the standards for a definition for advanced primary care standards and measurement with where care is actually heading. Where it is today, what really matters to delivery systems, payers, patients. So the program is organized across six domains, and again thanks to our pilot participants in helping us to really nail down these areas concretely population health management, coordinated team based care, patient safety and experience, behavioral health, clinical quality, and data management and exchange. So together, those are six particular areas and how we are defining what advanced primary care really looks like today. You heard from the panel proactive, team based, whole person, clinically excellent, and data ready. So on measurements, the measurements are grounded in HEDIS and aligned with the programs that delivery systems are already using. So eCQMs and the MIPS program, core sets, the universal foundation, our goal is to really reduce the reporting burden, not to add to it. One thing that I really want to highlight is that this model is intentionally designed to accredit at the highest level of accountability. So meaning the organization, not site by site. So for integrated systems, FQHC networks, large medical groups, that's a big shift for how they're used to approaching the PCMH model today. So instead of filling out an application for every individual site and going through those review cycles for every individual site, we'll be looking to consolidate that from an evaluation standpoint and recognize that at the highest level in terms of system or network infrastructure that you've already built once and then apply it across your site. So less paperwork, more time on care. And here's where I really, really, really need your help. Why we at NCQA really, really need your help. Public comment is open now. It closes July tenth. Your feedback can help us to confirm that the program is practical, that it's aligned with the real world care that you've heard about from the panel today and positioned to continue improving quality, health equity, the patient experience. We don't want this designed in a vacuum. Right? That's why we have the panel of pilot participants with us here today. We want it to be shaped by the people who are living and breathing the work every day. So whether you're within a practice, a system, if you're a health plan partner, or anywhere in between, we welcome you please, please, please weigh in. Next slide please. And here is how to submit your feedback. Use this QR code or the link that you see here to visit the NCQA website. You'll see more about the proposed model as well as the updates that we have out there for twenty twenty seven health accreditation. That's included in our public comment period too. You'll have some resources that you can access, but we want to be able to identify your feedback as you're going through the process. So those public comments are submitted through my NCQA dot org. There are step by step instructions included on the website, so we will walk you through that process for public comment, and that will run through July tenth at one minute shy of midnight. So all of those links will be available to you following the webinar today. Next slide, please. Now, let's take a little bit of time to address some pre submitted questions. Feel free to also submit via the q and a today. So we will follow-up after the call. We'll compile the questions. We'll compile answers, we'll send them out to you after the call. So the question that I see here, where do you see the advanced primary care model helping to create better alignment with payers, with purchasers, and partners compared to where things are today? And we got into a little bit of this already with our pilot participants, but I will welcome our participants to comment on that as you will. I can start. I would just say, you know, it's a mechanism for alignment. Right? We these are all complicated entities, and we need to align on what we're trying to do and define it in a similar way. And so having robust metrics that allow us to do that let us talk about the same thing at the, you know, at once. I mean, I I always tell the anecdote when I started it, you know, many years ago, Jefferson Primary Care was getting forty seven different dashboards for quality. Right? It was like and this is not a unique situation. Now we have one. Right? But I think that often our world feels that way where so many people are coming at us in so many directions that we we can't accommodate that because we're trying to see patients. Right? And and we can't deal with that level of noise. And by having a set of agreed metrics that I think people will be able to align on, instead of having noise, we start having meaning, and we can focus our efforts on doing the really hard work of delivering on those metrics and create that kind of alignment that the questioner, I think, is maybe asking about. Thank you very much, doctor Flatow. Other participants, anyone else from our panel? Yeah. And I would just add on that. I think that it's finally time that, we put together a perspective on what VBC is and what those metrics should look like. And then my hope is that, you know, as payers begin to look at this, we see just a broader consensus that the this is the right metrics because as, Anna had mentioned, you know, we received so many different contracts with so many different metrics, and we had to determine which ones we really want to measure. And so I think that once we have a a an aligned set, then I think it will just make the process easier for everybody to participate. Thank you, Noel. Bluegrass, New York City H and H, any thoughts to add? Just very quickly, I think that, you know, looking at metrics that will support best practices from the top all the way down to the front line is really, you know, going to be important, because the the work is done there. And if the work isn't understood and if the metrics aren't understood and they don't show, you know, positive outcomes and results, the work does not become standardized and consistent. So, you know, that that's what I'm most interested in as I deal a lot with those who manage the frontline and the work that they do. Excellent. Thank you, Cherilyn. Brandy, anything you care to add? No pressure. Don't think that I'm giving any pressure, but if you care to. No. Thanks for the opportunity. But, no, I think they they covered it pretty well. I I can just echo what they said. Perfect. Excellent. Well, thank you everyone. I think this is probably a good time trying to be mindful of the clock here. And I do see we have some questions coming in. Thank you for providing those for us. I do see some people are getting a four zero four error as they try to go to the public comment page. Just a takeaway for the NCQA team if we could make sure that folks are getting directed appropriately. Don't want anybody getting caught in the Internet black hole here. And, Jeff, I have I have one more question for our panel participants, and we just have about eight minutes. So we'll just do, like, a quick round robin, one one minute per organization. I'd love to get the perspectives from each of you. What advice would you give to primary care organizations that are looking for ways to move the needle on advanced primary care? So we'll start we can start with Alidade. Yeah. So I think and Jeff and others of NCQA, probably hear hear heard to say this all the time during our sessions is that focusing on outcomes is the most important thing, policies and procedures. If your outcomes are high, it most likely means that you have aligned policies and procedures to support those outcomes. So, I think if you focus on your outcomes, you know, everything will fall into place, and, you know, we we see that evident in our practices today. Thank you. Turning to Bluegrass. What guidance would you share, especially from an FQHC perspective? I would just say, to really spend some time planning and reviewing before trying to just jump in and implement. Oh, you know, I think I I shared before that I really wish I had involved more of my operations team, especially, like, the care team to help, help us navigate this. And, and like some of the others said, it's it's really important to focus on the data to identify the gaps and risks and and, track the outcomes. Thank you. So, next, let's bring in Jefferson. What lessons stand out to you from your experience that others can apply? I would say that it's so important just to hold close to the core values of high quality primary care throughout the entire journey. Even with very well defined and well constructed metrics, there is a thousand decisions in the journey to building programs or initiatives that support getting to the those outcomes. I mean, so for me, it's extremely important to consistently with our practices, but also honestly with everybody in our system, including those who may not be as familiar with how primary care works to relate the work we're doing, the metrics, but also all the micro decisions along the way to those fundamental values. I mean, that can be a north star, and it does lead to a stronger system that's stronger in delivering on the metrics and stronger on the underlying platform as well. Thank you. And finally, NYC Health and Hospitals, what advice would you offer organizations looking to scale advanced primary care across a large system such as yours? And that is the keyword, a large system. And, you know, our log in our large organization, it's important to connect stakeholders. I think communication is really important because we want everyone to benefit from the the advanced primary care, not just one place or the other. And so, you know, increasing communication, which is something that we've started to do through our dashboards, but I think we can connect better for the staff that is driving those dashboards, so that we have more of an integration of our system and a better understanding of how all of those systems work that fall into improving the advanced primary care outcomes. Awesome. Thank you so much for those insights. It's it's really great to hear the different perspectives across organizations of such varying size and structures as yours. So I'll turn it back over to Jeff to close us out. Thank you so much, Amy. And good news, everyone. It does appear as though that link is working now. So if you want to go back in, that should be all set up whenever you have an opportunity. I think we can jump to the next slide please, Hannah. Excellent. Registration is also now open for the twenty twenty six Health Innovation Summit with NCQA. This year's theme is quality's next chapter. If that doesn't pique your interest, I don't know what will. That reflects NCQA's commitment to advancing digital quality. We're modernizing measurement, reducing burden for the market, and also embedding equity into everything that we do. So doing that good work in partnership with clinicians, health plans, systems, communities, the summit is really intended to bring together quality leaders, if we're talking about payers, clinicians again, to technology partners, policy stakeholders, focusing on what matters most. So better strategies, measurable results, partnerships that can really help to move the quality agenda forward. So visit n c q a summit dot com to learn more. We hope to see you in Atlanta. If you see me there, wave, shake my hand, give me a hug if you're a hugger, grab a coffee with me. Maybe we can hit the aquarium together. I've never been, but I hear they have whale sharks. I'm a nature junkie. I'm very, very excited for the summit this year. So please, please check out the Health Innovation Summit. That is my infomercial for the day. If we can transition to the next slide. And now, my dear friends, we come to the end of our time together. Save your tears. I do hope that we'll have many more opportunities to interact. And as we close out, I do want to again give a very, very sincere thank you to each one of our pilot participants who served on the panel today. As always, and I know you all have worked with me enough, you know that I'll get modeling at the drop of a hat. It was an honor and a pleasure to have this and every conversation with you all. Thank you again and many thanks to all of you in the audience who joined us today. We hope that you enjoyed the discussion. I know Amy and I certainly did. And please don't forget to complete the post event survey that will pop up automatically as you close out the Zoom window. Thank you so much again today, and have a great day. We'll see you in public comment.