Episode #65 – Bringing Quality Into Healthcare with Peggy O’Kane, NCQA Founder & CEO

Our focus in this episode is on healthcare quality & safety.  Quality – its measurement, reporting and accountability – is one of the most significant, impactful and lasting healthcare movements, literally spanning the past four decades.  It is a core element of the ubiquitously adopted “Triple Aim”. And yet, it continues to be one of the most challenging problems plaguing healthcare delivery in our country.

Our guest this week is one of the pioneering leaders of the healthcare quality movement.  Peggy O’Kane is the Founder and CEO of the National Committee for Quality Assurance (NCQA).  She founded the NCQA 29 years ago, at a time when the idea of measuring and reporting standardized quality & safety metrics was largely not accepted by the medical establishment. Through her visionary leadership and her dogged persistence to make healthcare safer and of higher quality, the NCQA has grown to be the largest healthcare quality accreditation organization in the country.  The NCQA currently impacts 190 million Americans through its quality measurement and accredits hundreds of organizations. Peggy O’Kane has been named by Modern Healthcare as one of the “100 Most Influential People in Healthcare” 12 times, and one of the “Top 25 Women in Healthcare” 3 times.

In this interview, we’ll discuss:

• The core work of the NCQA –  identifying quality metrics and creating accountability around those metrics – and the challenges faced in its effort to do so.
• Why Peggy believes quality metrics are currently a tremendous burden for providers of care, and how we can change healthcare delivery to make quality reporting more sustainable for providers as well as for healthcare systems.
• Which specific mega-trends Peggy thinks are going to fundamentally transform healthcare delivery and how the NCQA is thinking about quality in the context of these seismic changes.
• Some of Peggy’s early thoughts regarding the new CMS ‘Primary Care First’ payment models which are set to launch in early 2020.  

Listening to Peggy O’Kane is one of those extraordinary opportunities to hear from a visionary healthcare pioneer and entrepreneur.  I tried to imagine how 30 years ago, a young female respiratory therapist decides to redirect the entire medical establishment in order to create standardization, transparency and accountability around quality metrics in healthcare. Peggy was clearly part of a larger “movement”; but still, I cannot fathom the enormity of that personal and professional undertaking, and the courage it took.

I also find it of immediate interest that, as Peggy points out, it was the employers and third party stakeholders who initially supported and promoted the launch of the NCQA quality improvement mission. I wondered, during the interview if, indeed, history is repeating itself. There is, I believe, a lesson to be learned from this history.  We are in a moment of profound and unprecedented transition in healthcare today and, once again, employers and third party payers are catalyzing transformative change – this time around value-based care. So, it does make me wonder. Do we have the luxury of time (decades) as we had in adopting the triple aim quality mission?  Or, is this new era of market-driven, consumer-oriented, value-based care going to demand a much more rapid response, with more negative consequences for those who delay? I’m curious as to how Peggy O’Kane would answer that question, and I’m also very interested in hearing your thoughts.

Until next time, be well.

Zeev Neuwirth, MD