MHR Newsletter

Driving healthcare quality one NCQA accreditation at a time

2024 #12
November 6, 2024
By: Nancy Ross Bell

From Susan

In 2021 NCQA pivoted from having a Health Care Congress that focused on the accreditation standards and initiatives to something much broader regarding health innovation with HEDIS and data updates. I attended most of the Congresses before this change and all three Summits since then.  Even though standards were not discussed, there were numerous NCQA people attending and the Summit featured an “Ask the Expert” segment for questions. It was clear that they listened to some of the feedback from the prior Summit(s).

This year’s Summit in Nashville included four tracks: Health Equity, Digital Quality, Value-Based Care, and Behavioral Health. Attendees could participate in any session without committing to a specific track.

NCQA draws national speakers, including those from the Centers for Medicare & Medicaid Services (CMS) and Capability Maturity Model Integration (CMMI), as well as thought leaders and innovators.  I particularly enjoyed the pre-conference workshop with Aswita Tan-McGrary, LaShawn McIver, MD, and Vanessa Guzman, each telling their moving story of why they are leaders in health equity and how it has framed their work.

A keynote by Dr. Robert Pearl discussed the use of AI in healthcare quality and highlighted distrust and payment models as significant barriers to AI adoption. At least one breakout session, the use of AI to assess admissions and readmissions was presented. If you haven’t yet used tools like CoPilot, Claude, Gemini, ChatGPT, Perplexity, Jasper, etc., the experience can be both exciting and daunting!  

One other keynote presentation I particularly liked was that on “Equity Across the Care Continuum.” I was especially excited that Toson Boyo from Sutter Health tied health equity activities with employee compensation within the health system. It reminded me of what Charlie Munger, billionaire and right-hand man to Warren Buffett, famously said about the corporate world, "Show me the incentive, and I will show you the outcome." For years, I’ve recommended to organizations that they link incentives to those involved in accreditation activities to assure employee engagement and success. I’d still love to see it happen. 

MHR Consultants Sonia Frazier and Monique Fields attended the Women in Quality reception and thoroughly enjoyed it.

Unfortunately, MHR does not have many clients in the accreditation area who attend the Summit. Some may think that if the topic does not address the standards, it might not be worth the time and expense, so organizations send HEDIS and data people instead. I encourage you to try to attend next year in San Diego at the Gaylord from October 10 -13, 2025.

Attending national conferences such as NCQA’s Summit helps to expand your thinking, promote creativity, and assist you in thinking at a higher level, along with being able to hear and network with those who have innovative solutions. Remember, you do not have all the time and resources, so learn from others' mistakes and successes. And, if you do come, you could join some of the MHR team and me as we again host the annual client dinner, meet you in person, and get to know you on a deeper level. It’s always a hit! 

In the News

For more highlights on NCQA’s Summit, click on the following links:

NCQA Health Innovation Summit: Day 1 Highlights

NCQA Health Innovation Summit: Day 2 Highlights

NCQA Health Innovation Summit: Day 3 Highlights

Templates, Tools and Trainings

Some organizations have asked about updates to our templates, tools, and training based on the 2025 standards.  Be assured that our consultants are working through the changes and will have them ready no later than in the first quarter of 2025.  However, if you have a high priority “now,” please let us know.

Model of Care (MOC) Reviews for Special Needs Plans (SNPs)

The time is “now” to request a review of a CMS MOC for Special Need Plans. NCQA is designated by CMS to review MOCs before they are submitted to CMS. MHR Consultant Jean Lockington conducts these reviews for MHR non-clients, avoiding any potential conflict of interest.

If you are not a current client, please reach out to Susan to schedule a Discovery Call and learn how we guide organizations on their path to NCQA Accreditation.  

 MHR CONSULTATION + TOOLS + TRAINING = NCQA SUCCESS

Webinars and Events

December 13, 2024: MHR Client Webinar Training (noon ET) It’s time to register

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March 6, 2025: Update to the 2025 NCQA standards (2:00 ET) Save the date

April 7-8, 2025: NCQA Health Equity Forum 2025 (Baltimore, MD)

MHR was incorporated in 1991 and specializes in preparing organizations for all NCQA accreditation and certification products.

All MHR consultants were responsible for NCQA accreditation in their previous roles before joining MHR as an independent consultant. Most consultants are also NCQA surveyors and the majority are clinicians. Read more about How We Work!

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