Uniting for Healthcare Quality at the NCQA Summit
Connecting Through Superpowers
The industry leader at the NCQA's Health Innovation Summit emphasized the extraordinary power of connecting with each other. This summit, with its diverse participants, aimed to bring together leaders and innovators around a common goal of enhancing healthcare quality. As seen at the 2024 summit, various topics were addressed, including value-based care and health equity.One panel, "Women in Quality," provided unique perspectives from five female healthcare leaders. Guzman moderated the discussion, highlighting the importance of community, leadership, and personal growth. Key themes like integrity, trust, and personal stories were emphasized.O'Kane, as the leader of NCQA, not only accredits health plans but also patient-centered medical homes, with a focus on quality and health equity.Embodying Leadership and Integrity
The panel started with a crucial question about embodying leadership. O'Kane simply stated that showing up is key after 34 years in the job. The panel's insights included remembering that every day is a job interview, acting with integrity even when unobserved, leaning into personal traits to influence leadership style, leading with purpose, curiosity, and integrity, and balancing personal and professional roles.Using the "Kitchen Table"
The concept of the "kitchen table" was discussed, emphasizing the importance of support networks. Guzman asked about the significance of the kitchen table and how it supports core values. O'Kane highlighted the superpower of women in connecting with each other and shared an example from another NCQA HIS panel. Harris' work on enhancing access to diabetes digital therapeutics showed the impact of data and personal connection. This example demonstrated how one can forget one's ego and focus on a greater cause.Overcoming Imposter Syndrome
Building and leading a culture of quality, equity, and trust can be intimidating, especially for women who often struggle with imposter syndrome. The panel discussed how to overcome this, with responses ranging from leveraging unique perspectives to creating peer mentoring groups. O'Kane emphasized the importance of trust in building culture and the need to address the widespread contemptuous distrust in society.Final Thoughts
The NCQA HIS session concluded with key takeaways for the audience. These included doing homework and asking specific questions when seeking mentorship, embracing one's power and creating paths for others, and being conscious of living in one's truth and the impact of simple acts of kindness. O'Kane's powerful answer to the final question emphasized the importance of living in all aspects of life and not being limited by work.Laura Beerman, a freelance writer for HealthLeaders, was present to capture these important insights.Uncovering the Hidden Challenges of Healthcare and Food in Specific Areas
Healthcare Access in Poorly Served Areas
Many areas face the unfortunate reality of having poor access to healthcare. This lack of proximity to medical facilities can lead to delayed diagnoses and difficulties in receiving timely treatment. For example, in some rural communities, the distance to the nearest hospital can be several hours away. This not only poses a burden on patients but also affects the overall health outcomes of the population. Studies have shown that in such areas, the prevalence of certain diseases is higher due to delayed medical attention.
Moreover, the limited availability of healthcare providers in these regions can further exacerbate the problem. There may be a shortage of doctors, nurses, and other medical staff, making it even more challenging for residents to access the care they need. This shortage can also lead to long waiting times for appointments and procedures, adding to the frustration and inconvenience of seeking medical help.
Food Deserts and Their Impact
Another significant issue is the presence of food deserts in these same areas. Food deserts are defined as areas with limited access to fresh and nutritious food. Instead, residents are often left with limited options such as convenience stores that primarily sell processed and high-calorie foods. This lack of access to healthy food can have a detrimental impact on the health and well-being of the community.
Research has indicated that individuals living in food deserts are more likely to suffer from diet-related diseases such as obesity, diabetes, and heart disease. The absence of fresh produce and healthy food options makes it difficult for people to maintain a balanced diet and make nutritious choices. This, in turn, can lead to a cycle of poor health and increased healthcare costs.
The Interconnection Between Healthcare and Food
The relationship between healthcare and food is undeniable. Poor access to healthcare can make it difficult for individuals to manage their chronic conditions and prevent the onset of new diseases. At the same time, a diet lacking in essential nutrients can weaken the immune system and make individuals more susceptible to illness.
For example, a person with diabetes who lives in a food desert may have limited access to the proper medications and supplies needed to manage their condition. Additionally, the lack of healthy food options can make it challenging to follow a diabetic diet, further complicating their health situation. On the other hand, providing access to fresh food and improving healthcare services in these areas can have a positive impact on the overall health of the community.
Trump's Healthcare Choice - A Battle for the Middle Class
Trump's Impact on Healthcare Subsidies
Trump will play a crucial role in deciding the fate of government money for healthcare plans. Letting the ACA subsidies expire could lead to savings for the government but could also result in higher premiums for the middle class. This decision will have a direct impact on the healthcare options available to people and families who rely on these subsidies.President Joe Biden's enhanced ACA subsidies, which have been providing lower premiums and reduced out-of-pocket costs for Americans on Medicare and Medicaid, are set to expire in 2025. At that point, Trump and a Republican-led Congress will need to decide whether to renew or end these subsidies. The potential consequences of this decision are far-reaching.
Ending the subsidies would save the government money but could restrict healthcare options for those who need them. According to the Congressional Budget Office, nearly 4 million people could drop coverage in 2026 if the subsidies expire. This highlights the importance of this decision and its impact on the lives of millions.
The Affordable Care Act and Its Expansion
The Affordable Care Act, also known as Obamacare, was passed in 2010 and has had a significant impact on healthcare enrollment and access. It requires insurance companies to cover preexisting conditions and has boosted the number of people with federal insurance programs like Medicare and Medicaid.Biden's expansion of the ACA has increased financial assistance for those already on ACA plans and lifted the income eligibility cap. This has made healthcare more accessible for some middle-class families who were previously priced out. Since 2020, the number of people with ACA marketplace coverage has grown by 88%, from 11.4 million to 21.4 million.
However, the future of these subsidies and the ACA itself remains uncertain. Trump's stance on healthcare and his cost-cutting agenda could lead to significant changes in the healthcare landscape.
The Cost-Cutting Agenda of Trump's Second Term
The US government spent $6.75 trillion in fiscal year 2024, with healthcare being a top expenditure behind Social Security. Medicare costs add another $874 billion. If the enhanced ACA subsidies were to become permanent, it would cost $335 billion over the next 10 years.Tesla CEO Elon Musk and former GOP presidential candidate Vivek Ramaswamy have been tapped by Trump to lead a new Department of Government Efficiency. They plan to propose cuts for the government's most costly programs, including Medicare and Medicaid. Trump's nominees for the top healthcare positions, such as Robert F. Kennedy Jr. leading the Department of Health and Human Services and Dr. Mehmet Oz leading the Centers for Medicare and Medicaid Services, have not outlined specific plans for affordable healthcare.
In an opinion piece in 2020, Oz said he supports a universal healthcare plan, but this stance may be at odds with the Trump administration's cost-cutting agenda. Any move by Trump to change ACA policies would need congressional approval, and insurers need to submit their plan proposals next summer for the 2026 enrollment period.