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In this episode of “Inside Health Care,” Peggy O’Kane, NCQA President, talks with Frank Micciche, NCQA VP of Public Policy and Communications, about what she learned from 2020, including her rediscovery of the importance of public health and its links with the private sector. Peggy and Frank also discuss NCQA’s priorities for 2021 and beyond: Digital quality measures, multicultural health care, telehealth and more.

Dr. Douglas Jacobs In this episode of Inside Health Care, Dr. Douglas Jacobs, Chief Innovation Officer of Pennsylvania’s Department of Human Services, chats with Eric Musser, NCQA Deputy Director of State Affairs about his background, how Pennsylvania responded to COVID-19 and built equity inside the department in response to America’s racial reckoning in 2020. Dr. Jacobs also talks about incentivizing Medicaid managed care organizations to close disparities, how NCQA’s Distinction in Multicultural Health Care fit into the department’s larger health equity goals and the biases of algorithms in health care.

Vanessa Guzman of SmartRise Health In this episode of Inside Health Care, Vanessa Guzman, CEO of SmartRise Health, chats with NCQA’s Lawrence Green about accountable care organization (ACO)-payer partnerships, risk value-based payments and improving quality in cost-related metrics. Vanessa discusses ACO and payer priorities, successful ACO-payer models and the role of quality measures in an ideal strategy. Vanessa also talks about the key elements for building an ACO-payer infrastructure to support quality in value-based arrangements and how data can help build partnerships for closing gaps in care and addressing social determinants of health. Learn about NCQA’s Digital Quality Community here.

Vanessa Guzman of SmartRise Health In this episode of Inside Health Care, Vanessa Guzman, CEO of SmartRise Health, chats with Matt Brock, NCQA Director of Communications, about the intersection of gaps in care, population health and quality reporting. Vanessa discusses the role of preventive health, behavioral health and social determinants of health in closing care gaps. Vanessa also talks about leveraging data to close gaps in care and the role technology and artificial intelligence play in improving population health outcomes. Learn about NCQA’s Digital Measurement Community and chat with us in the forum here.

Danielle Brooks of AmeriHealth Caritas In this episode of Inside Health Care, AmeriHealth Caritas’ Danielle Brooks, Director of Health Equity, chats with Dr. Michael Barr, NCQA Executive Vice President, about “The Return on Investment for Health Equity and Quality Improvement,” her presentation at this year’s Digital Quality Summit. Danielle also discusses the disproportionate effect of COVID-19 on communities of color and how this might impact addressing health disparities, measures to take when collecting data to address health equity and the importance of having diverse ethnicities and voices in the room when developing health care products. Learn more about NCQA’s Digital Quality Community here.

Ashlee Wisdom of Health In Her Hue In this episode of Inside Health Care, Ashlee Wisdom, CEO and founder of Health In Her Hue, chats with NCQA’s Lawrence Green about the importance of connecting Black women with culturally competent health care providers, telehealth services and health information that centers Black women’s lived experiences. Ashlee addresses how the roots of America’s health care system align against the interests of Black women and how she’s helping to change the narrative around health equities. Ashlee also discusses how she built Health In Her Hue, user and patient responses to the website and app and the limitations of technology for providing systemic change in health care. Don’t forget to check out NCQA’s Quality Innovation Series, featuring talks and seminars from health care experts, live and on-demand. And rate Inside Health Care on your podcast streaming platform!  

Dr. Adrienne Mims Courtesy of JenCare Senior Medical Center In this episode of Inside Health Care, Peggy O’Kane, NCQA President, and Dr. Adrienne Mims, former Vice President and Chief Medical Officer for Alliant Health Solutions, current health care provider at Jencare Senior Medical Center discuss Dr. Mims’ multifaceted professional background, EHR use, solutions to health disparities and motivating chronically ill patients. Dr. Mims also addresses how COVID has changed primary care for older patients, the emergence of telehealth and discussing end-of-life issues with patients. Don’t forget to check out NCQA’s upcoming Quality Innovation Series, which features talks and seminars from health care experts, live and on-demand. And rate Inside Health Care on your podcast streaming platform!

In this episode of Inside Health Care, NCQA’s Dr. Mary Barton, Vice President of Performance, chats with Matt Brock, NCQA Communications Director, about the implications of two major study retractions from prestigious medical journals during the COVID-19 pandemic. Dr. Barton talks about the level of expertise needed to review journal articles, ensuring data quality standards and the incentive for journals to publish groundbreaking studies first. Dr. Barton also discusses how the novelty of COVID-19 is affecting the peer review process, the development and implementation of scientific knowledge and the challenges and benefits of collecting electronic clinical data in this digital age. Learn more about NCQA’s Digital Quality Community here.

We return to the Policy Primer for this edition of Inside Health Care.  The aim is to explain complex health care issues in a simple, readily understandable way for policy experts… and others who may not be brushed up on the details. NCQA’s Director of Federal Affairs Paul Cotton joins us again to talk about the Taskforce on Telehealth Policy and it’s efforts to map a future for the newly embraced way of delivering care.  The committee releases its final report today. You can check it out at    bit.ly/TTPFinalReport. Inside Health Care, What to Expect This discussion covers the Taskforce on Telehealth Policy, the issues the Taskforce considered and how each applies to providers, plans and, most importantly, patients. NCQA’s Matt Brock hosts. Check out the blog that goes along with this discussion. 

There’s something new for this edition of “Inside Health Care.”    We’re calling it Policy Primer. We want to explain complex health care issues in a simple, readily understandable way for policy experts… and others who may not be brushed up on the details. This time, NCQA’s Director of Federal Affairs Paul Cotton joins us to talk about the Taskforce on Telehealth Policy and it’s efforts to map a future for the newly embraced way of delivering care.  The committee releases its final report on September 15, 2020 at 2PM ET.  Register now at bit.ly/TelehealthReport. Inside Health Care, What to Expect This discussion covers the Taskforce on Telehealth Policy, the issues the Taskforce considered and how each applies to providers, plans and, most importantly, patients. NCQA’s Matt Brock hosts. Check out the blog that goes along with this discussion. 

In this episode of Inside Health Care, Dr. Daniel Alford, Professor of Medicine at Boston University and Director of Safer/Competent Opioid Prescribing Education (SCOPE) of Pain Program chats with Lawrence Green, NCQA Communications Specialist about the SCOPE of Pain Program. SCOPE of Pain is a series of continuing medical education/continuing nursing education activities designed to help health care professionals safely and effectively manage patients with acute and/or chronic pain, when appropriate, with opioid analgesics. Dr. Alford discusses the inception, goals, focus, and target audience of SCOPE of Pain. Dr. Alford chats about how SCOPE of Pain has evolved to train over 190,000 health care providers and how COVID-19 has affected training efforts. Dr. Alford also talks about managing patients who are currently on long-term opioids and/or high dose opioids and barriers to opioid prescribing today. Don’t forget to check out NCQA’s upcoming Quality Innovation Series, which features talks and seminars from over 50 health care experts, live and on-demand September 17 – December 4.

In this episode of Inside Health Care, Peggy O’Kane, NCQA President, and Dr. Vivian Lee, President of Verily Life Sciences, discuss Lee’s book, The Long Fix: Solving America’s Health Care Crisis with Strategies That Work for Everyone. Dr. Lee lays out a concrete plan for paying doctors, hospitals and pharmaceutical companies to keep people healthy while improving care and decreasing patients’ health care costs. Dr. Lee also talks about her childhood motivations for pursuing medicine, how delivery of care has changed in America and Verily Life Sciences’ cutting-edge, personalized health care products. Don’t forget to check out NCQA’s upcoming Quality Innovation Series, which features talks and seminars from 47 health care experts, live and on-demand September 17 – December 4.

In this episode of Inside Health Care, Wendy Talbot, Assistant Vice President, Measure Collection & Audit and Lawrence Green, Communications Specialist, discuss the NCQA HEDIS Compliance Audit process and NCQA’s Data Aggregator Validation (DAV) pilot program. The Compliance Audit helps ensure accurate, reliable data can be used by employers, consumers and government to compare health plans.. The DAVpilot program seeks to validate data aggregators that collect electronic clinical data from multiple sources to share with healthcare organizations as validated standard supplemental data for use in HEDIS and other quality measure reporting. In this episode, Wendy discusses the Compliance Audit’s importance and challenges, and describes the DAV pilot program’s main goals, development process, target organizations and future plans. Learn and collaborate with people who develop, use and support digital quality measures at www.ncqa.org/digital-measures/.

In this episode of Inside Health Care, Dr. Brad Ryan, NCQA’s new Chief Product Officer, and Matt Brock, NCQA Communications Director, discuss Brad’s experience and background in science, engineering and technology, and his mission to evolve NCQA’s existing product portfolio and launch new products in the digital space. Dr. Ryan also talks about how collecting and using EHRs more readily could improve the quality of care and shares his vision of NCQA as a thought leader in determining the future of telehealth policies.

In this episode of “Inside Health Care,” Scott Meyer, Executive Director of Value Based Care Operations at Summit Medical Group (SMG) in Tennessee and Matt Brock, NCQA Communications Director, discuss how NCQA’s Recognized Patient-Centered Medical Home (PCMH) Program transformed SMG’s more than 70 practices. Scott examines how NCQA’s PCMH Recognition program helped SMG quickly adapt to serve the needs of patients during the pandemic. He talks about how the Recognition program shares a “universal language”that aligns with CMS, and the financial benefits of delivering value-based care. Scott also divulges that he was not a big fan of NCQA at first, and tells us what led him to embrace PCMH Recognition.

In this episode of “Inside Health Care,” Peggy O’Kane, NCQA President, moderates an expert panel discussion to explore how health plans, systems and clinicians are using telehealth to respond to COVID-19 and how challenges and opportunities identified during the pandemic might inform the future. Panelists are Dr. Yul Ejnes, Clinical Associate Professor of Medicine, Warren Alpert Medical School of Brown University; Kerry Palakanis, Executive Director of Connect Care Operations, Intermountain Healthcare; Dr. Hoangmai Pham, Vice President of Provider Alignment Solutions, Anthem; and Dr. Michelle Schreiber, Director of the Quality Measurement and Value Based Incentives Group at CMS. In part 1* of this discussion, panelists share their thoughts about the adoption, capabilities and limitations of telehealth. In part 2, panelists answer a range of questions covering reimbursement, privacy concerns and resources for keeping up with telehealth developments. Learn about newly enacted policies for NCQA staff, contractors and events due to the coronavirus here: https://www.ncqa.org/covid/. *The Commonwealth Fund created the slides mentioned during part 1, documenting the growth of telemedicine during the pandemic.

Dr. Michael Barr, Executive Vice President, Quality Measurement and Research Group In this episode of “Inside Health Care,” Dr. Michael Barr, NCQA Executive Vice President, Quality Measurement and Research Group, and Matt Brock, NCQA Communications Director, discuss how telehealth has transformed the delivery of care during the COVID-19 pandemic. Dr. Barr discusses his experiences with telemedicine and how primary care practices are adjusting to this new reality. We also discuss the direction of NCQA during this time. Learn about newly enacted policies for NCQA staff, contractors and events due to the Coronavirus here: https://www.ncqa.org/covid/.

In this episode of “Inside Health Care,” Peggy O’Kane, NCQA President, and Frank Micciche, NCQA VP of Public Affairs and Communications, discuss the importance of public health during the COVID-19 crisis: how COVID-19 is affecting American society as well as quality measurement—and NCQA. Peggy also talks about building a telehealth infrastructure and how the virus is disproportionately impacting African Americans, Hispanics and the underprivileged. Listen to the podcast below. Learn more about enacted policies for NCQA staff, contractors, and events due to the Coronavirus here: https://www.ncqa.org/covid/. Don’t forget: Quality Talks 2020 is April 28. Join us virtually! Register at www.qualitytalks.org.

In this episode of “Inside Health Care,” Delia Brand, Director of Alabama Tombigbee Regional Commission Area Agency on Aging (AAA), and Matt Brock, NCQA Communications Director, discuss how NCQA’s Accreditation of Case Management for Long-Term Services and Supports provides a framework for improving the quality of care. Delia describes how NCQA’s LTSS Best Practices Academy helped Alabama’s 13 AAA’s prepare to apply for Accreditation and how the application process led to better coordination of care. Delia also talks about Alabama AAA’s diverse client population and the benefits of delaying institutional care. Listen to the podcast below. Don’t forget: Quality Talks 2020 is April 28. Register at www.qualitytalks.org.

Thomasene Barnes, of New York Health and Hospitals, Peggy O’Kane of NCQA and Kelsey Keller, of Hackensack Meridian Health. In this episode of “Inside Health Care,” Thomasene Barnes, of New York Health and Hospitals, and Kelsey Keller, of Hackensack Meridian Health, discuss their PCMH Certified Content Expert (CCE) Quality awardwinning efforts with Matt Brock, NCQA Director of Communications. Thomasene and Kelsey talk about their innovative strategies for improving patient-centered care. They also discuss their leadership techniques, motivations and impressions of the PCMH Conference. On October 6, CCE Awardee Thomasene Barnes will present CCE Quarterly: Building an Organizational Culture of Quality: Sustaining PCMH. Join us for this webinar training! CCEs play an integral role in helping a practice transform into a PCMH. NCQA is currently accepting nominations here from Recognized practices for the 2020–2021 PCMH CCE Quality Award. Winners will be announced in September at the PCMH Congress in Dallas, Texas. Register for PCMH Congress and the upcoming CCE Quarterly webinar before spaces sell out!