Episode Details

“We need to be more ambitious….”

Margaret “Peggy” O’Kane transformed healthcare quality measurement in America when she created NCQA 35 years ago. As she reflects on what it has meant to create the foundations for quality measurement, she is also clear that the complex state of healthcare requires leaders across payers, health systems, employers, and providers to do more. Disruption is required.

In this revealing conversation with Laurie McGraw, O’Kane reflects on her journey from respiratory therapist to healthcare quality pioneer, the development of HEDIS® as the nation’s most widely used quality measurement tool, and her passionate advocacy for addressing racial disparities in healthcare outcomes. As she prepares to retire at the end of 2025, O’Kane shares candid insights on the challenges facing healthcare quality improvement and her vision for the industry’s future. Discover why this legendary leader believes that despite progress, “so much work that’s undone” in creating a trusted, quality healthcare system.

O’Kane’s unwavering commitment to health equity shines through when she addresses recent pushback on measuring disparities: “There are undeniable differences in health outcomes among different population groups… I think people need to be determined to push through, to learn about how to approach this.” Her call for persistence resonates powerfully as she urges healthcare leaders to “follow the data, avoid the noise… and stay ambitious and courageous” in addressing healthcare disparities.

Key Takeaways:

1. Quality Measurement Evolution: O’Kane’s journey with NCQA began by addressing the disorganized state of healthcare, evolving from basic preventive measures to comprehensive digital quality metrics that can transform population health management.

2. Digital Transformation: The future of healthcare quality lies in digital reporting and enablement, moving beyond traditional HEDIS® measures toward more ambitious, customized approaches that can better serve diverse patient populations.

3. Health Equity Imperative: Despite political pushbacks, O’Kane emphasizes the critical importance of continuing to measure and address healthcare disparities through data-driven approaches, including innovative methods like using zip codes when direct demographic data collection faces challenges.

4. System Transformation Challenges: O’Kane acknowledges that transforming healthcare requires changing deeply ingrained practices, noting that “everybody’s been trained to work in the current model” and meaningful change requires persistence, curiosity, and willingness to adapt when approaches aren’t working.

Guest Resources:

• National Committee for Quality Assurance (NCQA)
• Healthcare Effectiveness Data and Information Set (HEDIS®)
• LinkedIn

About Margaret (Peggy) O’Kane:

Margaret “Peggy” O’Kane is the founder and president of the National Committee for Quality Assurance (NCQA), an organization she established in 1990 to transform healthcare quality measurement and improvement in America. After recogn