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What to Expect at Health Care Quality Congress 2019, An Official Conference by NCQA

Returning this October 2-4 in Dallas, TX is Health Care Quality Congress (HQC) 2019, an official conference by NCQA. This meeting was formerly offered as two regional meetings focused on health plan accreditation and HEDIS and was merged successfully in 2018. (Disclosure: HQC is produced by HMP Global, the parent company of HMP, the publisher of First Report Managed Care.) HQC offers exclusive education opportunities, as well as first looks at results from the annual release of the Health Plan Accreditation standards and HEDIS measures data directly from NCQA. Attendees of HQC will have the chance to ask questions, learn about the latest developments directly from industry experts, and discover ways to develop their organizations offerings in high-quality, value-based care. 

HQC is carefully designed to cater to health care professionals who manage, implement, and assess Health Plan Accreditation survey processes, as well as professionals who gather, analyze, or report HEDIS data. HQC also provides extensive networking opportunities for peers and experts, alike. 

As a preview, First Report Managed Care has compiled an abridged overview of the meeting and the educational sessions offered that would best serve managed care professionals attending the conference. Please refer to the final program and meeting website ( for a complete list of sessions, workshops, exhibitors, and other conference events.


New to the 2019 HCQ Congress, attendees will have access to the NCQA Solutions Center, the one-stop place for everything population health and care quality related. The Solutions Center will provide an opportunity to connect with NCQA staff, steering committee members, and NCQA leadership. Attendees will be able to get answers about accreditation and HEDIS, as well as connect with colleagues to expand their network. (Open during breaks, lunch, and Exhibit Hall time.)


HQC education tracks include best practices, health plan accreditation, and HEDIS. 

Additionally, the conference will be divided into a series of sessions, workshops, and industry-supported symposia covering a range of topics offering attendees their first in-person opportunity to review the annual NQCA updates. Key topics include:

  • HEDIS Audit and Roadmap Changes Review
  • New Measures in the Pipeline
  • Health Plan Accreditation Standards Updates
  • Changes to Complex Case Management
  • Updated Utilization Management Timelines


Innovation Awards

Featuring Quality Accelerators in Health Care will recognize health plans for implementing leading-edge strategies that improve both quality and value; and health plans that support delivery system redesign and patient engagement initiatives that help drive better integration across the various levels of the delivery system and support person-centered care. Awards will be announced and presented at the HQC, Wednesday, October 2, 2019.



Wednesday, October 2, 2019

8:15 AM-9:15 AM

Population Health and Quality—Two Peas in a Pod!

David Nash, MD, MBA, founding dean emeritus, Jefferson College of Population Health, Thomas Jefferson University, will share key insights on the concepts and approaches to managing population health to improve health care quality. Attendees will learn the answer to the question “How does optimizing population health management enable your health plan to not only meet but exceed existing accreditation standards?”


10:35 AM-11:35 AM

The Power of Partnerships in the
Ever-Changing Health Care Continuum

Ambria Moore, BA, PMP, and Denise Parker, delegate oversight project managers from BlueCross BlueShield, will divulge how to promote operational excellence and drive positive change through unique partnerships in managed care. Speakers will discuss BlueCross BlueShields’s  Delagate Oversight Program and outline latest results and progress. Attendees will learn how to create a holistic approach to collaborating with internal and external partners by developing joint processes, standard performance monitoring and audit tools, checklists, and internal controls.

11:45 AM-12:45 PM

Addressing Social Disparities and Health Quality: Using Value-Based Models to Build Communities of Care

Vanessa Guzman, MS, MEng, associate vice president, quality and network management at
Montefiore Health System shares insight on how to effectively construct and negotiate sustainable agreements with payers that prioritize integration of social determinants and health
equity and patient-centered medical home, while
reducing costs and improving patient experience.

3:25 PM-4:25 PM

The Collaborative Care Impact Model: Impacting Cost, Access, and Clinical

Nicole Andrews, MPH, project manager at PCDC, will discuss the benefits of utilizing the Collaborative Care Impact Model, in efforts to control costs, improve access and outcomes, and improve patient satisfaction in a variety of primary care settings. Attendees will learn more about seeing primary care settings as a gateway to the behavioral health system, including how to better integrate services to reduce hospital admissions and emergency department visits.


Thursday, October 3, 2019

8:00 AM-9:00 AM

Using Patterns of Behavior to Our
Advantage: Behavioral Economics
and Improving Health Care Quality

David Asch, MD, MBA, executive director at Penn Medicine for Health Care Innovation, discusses the relatively new field of behavioral economics and how examining the data from a different direction will help health care professionals improve health and health care utilization. 

10:20 AM-11:20 AM

Reframing Healthcare:
A Racial Justice Lens

Karen Evans, RN, BSN, CLNC, CPHQ, PCMH CCE, senior program administrator, and Radhika Sabnis, MS, MBA, program coordinator, both from Healthcentric Advisors, will explain the differences between internalized racism, interpersonal racism, institutional racism, and structural racism and help participants understand how the history of structural and institutional racism impacts health outcomes today. Attendees will learn about credible tools and resources and be provided with practical examples to start or further health equity work within their own organizations.


3:10 PM-4:10 PM

Care Coordination in the Medical
Neighborhood: Practical Applications from the Primary Care and Health
System Points of View

Richard Dom Dera, Jr, MD, FAAFP, advanced primary care medical director at NewHealth Collaborative, and Nancy Myers, PhD, vice president of leadership and system innovation at
the American Hospital Association, will describe care coordination from both the primary care teams’ and health systems’ point of view, identifying areas where the two entities can work together to achieve improved care coordination.


4:20 PM-5:20 PM

Targeting Care Gaps: The Role of In-home Medical Delivery in Value-based Care 

Michael Le, MD, cofounder and chief medical officer of Landmark Health will discuss how as value-based care continues to gain momentum, there is a positive shift to long-term outcomes of complex patients. This plenary session will explain how provider experience, extended time with patients, and proper documentation training positively impacts quality measures. 


Friday October 4, 2019

8:50 AM-9:50 AM

How to Optimize the HEDIS Off-season for Best Results

Branka Sustic, vice president of quality at Cotiviti, and Efe Igbide, senior data quality program manager at BlueCross BlueShield, will offer a timeline and practical tips for health plans to prepare during HEDIS off-seasons to improve performance during the next HEDIS season. As quality departments continue to take on a growing number of state-specific and other quality measures spanning several programs, it is critical for them to remain focused during the HEDIS off-season to better prepare when January comes.


12:30 PM-1:30 PM

Medicare Advantage (MA) and Medicaid Deeming

Leticia Addai, JD, MPH, assistant director of accreditation policy at NCQA, will provide an overview of the newly released MA Deeming Module and the NCQA Health Plan Medicaid Module. Participants will understand how the MA Deeming Module can help reduce the Centers for Medicaid & Medicare audit burden on Special Needs Plans, as well as how the Medicaid Module can support NCQA-Accredited health plans with streamlined state compliance


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