This episode of Quality Matters examines primary care’s evolving role and features Karen Johnson of the American Academy of Family Physicians and Jeff Sitko of NCQA.

Karen and Jeff outline primary care’s distinguishing focus on patient relationships, the strain on the primary care workforce, and technology’s promise to ease burdens. The discussion connects the dots between workforce sustainability, AI-driven efficiency, payment reform, and NCQA’s vision for next-generation primary care.

Karen highlights the underappreciated fact that only 5% of health care spending goes to primary care, despite public perception that the figure is—and should be—higher. Jeff describes a dawning era of proactive, data-driven care delivery. He also previews NCQA’s plans to build upon the successful Patient-Centered Medical Home model of primary care.

• The Human Core of Primary Care: Continuity and trust are what make primary care special, even as practice settings change.
• Workforce Challenges and Opportunities: Clinicians report high stress and burnout, yet relationships with patients keep them engaged. Building systems that protect these relationships—and make primary care careers attractive—is critical to sustainability.
• Economics and Incentives: Guests discuss new payment models, state-level initiatives and federal efforts to rebalance incentives and support primary care in new ways.
• Looking Ahead: The foundational Patient-Centered Medical Home model gets an update in 2026. Plus, Karen calls for a seismic shift to resource primary care as a common good.

This episode is essential listening for healthcare executives, policymakers, and clinicians committed to strengthening primary care as the cornerstone of quality improvement.

Key Quote:

If you want to boil it down to the simplest terms, it's taking primary care from a reactive model—Call me when you're sick; I'll put you on my schedule; Come in and see me—to a proactive model.

I am paying attention to a population of patients. They're mine. They're on my panel. And now maybe they're also tied to some accountability arrangement in value-based care, where performance comes into play.

And so I'm going to be proactive for a lot of reasons. One, it's the right thing to do for patients. But I also want to make sure my patients are getting preventive services they need, they are taking the medications I prescribe, they are going to the referral I recommended. And I'm getting the information back from that physician, and my team is acting on that. It's all of those things that should be ubiquitous in primary care.

-Karen Johnson, PhD

Time Stamps:

(01:07) The Changing Landscape of Primary Care

(06:42) Challenges in the Primary Care Workforce

(08:49) How Technology is Impacting Primary Care

(15:59) Future Directions and Innovations

(18:11) NCQA's Plans for 2026

Dive Deeper:

State of the Primary Care Workforce 2024 (HRSA)

The Pulse of Primary Care (JGIM)

Connect with Karen Johnson

Connect with Jeff Sitko

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this year-end episode of Quality Talks, Peggy O’Kane, NCQA’s founding President, sits down with Dr. Vivek Garg, incoming President and CEO.

Together, they reflect on Peggy’s 35-year legacy of building the nation’s first quality measurement and accreditation programs, and discuss the future of NCQA under Vivek’s leadership. From embedding quality measurement into medical practice to tackling fragmentation and misaligned payment incentives, this episode captures both the persistence required to drive change and the optimism for what lies ahead.

Peggy shares candid reflections on the quality movement’s achievements, including the creation of national standards and her push to make quality measurement more clinically relevant. Vivek offers personal insights shaped by his family’s health care journey, his career in value-based care, and his vision for advancing interoperability, chronic condition management and specialty care integration.

This conversation, Passing the Quality Torch, is a must-listen for health care executives, policymakers and clinicians committed to building on quality’s decades of success to create a more data-driven and sustainable health care system.

Highlights:

• Origins and Transformation of Quality Measurement: Peggy recounts the shift from outdated peer review models to building the first national measurement and accreditation systems, setting the foundation for modern health care standards.
• Leadership, Persistence and Collaboration: The conversation highlights the need for resilience and adaptability in driving change, plus the need for teamwork within and across disciplines.
• Technology’s Role in Reducing Burden: Both leaders emphasize how tech-driven solutions can streamline medical practice, remove inefficiencies and reduce clinicians’ burden.
• Chronic Condition Management and Specialty Care Integration: Vivek underscores the need for longitudinal care strategies and better coordination between primary and specialty care.

Key Quote:

“We have an opportunity to work together with the community to say, 'Let's plant our flag. What is that next aspirational vision?’ Because the standards are part guidepost and part instruction manual. But they reflect this commitment across the community that we can be better, and we can define what that looks like. And some of us are gonna go for it. So I'm excited about all of those areas.”

-- Vivek Garg, MD

Time Stamps:

• (02:42) Reflections on 35 Years of Quality
• (6:59) Peggy’s Prescription
• (10:50) Vivek’s Path to NCQA
• (15:52) Vivek’s Vision for the Future
• (18:27) We All Have a Role in the Transformation to Come

Links:

Connect with Vivek Garg

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This episode of Quality Matters features Rupa Valdez, Professor at the University of Virginia; Polina Lissin, NCQA Senior Healthcare Analyst; and Elizabeth Ryder, NCQA Assistant Director of Product Management.

Together, they unpack the meaning of disability in health care, the importance of self‑identification and how NCQA is working to improve outcomes for people with disabilities. The conversation bridges academic, policy and real-life perspectives, making a compelling case for why disability is central to quality improvement.

Listen to learn about:

• Disability and Destiny: One in four Americans has a disability. That prevalence understates everyone who will have a disability.
  
• Defining and Measuring Disability: Policymakers and disability advocates agree that people with disabilities should define their own disability status. Measures of population health and quality must adjust accordingly.
  
• NCQA’s Contributions and Innovations: New standards for Health Outcomes Accreditation and the Disability Description of Membership measure in HEDIS 2026 show disability can be a valuable lens for assessing quality.
  
• Designing for Inclusion: From curb cuts in sidewalks to adjustable exam tables, accessibility is a design principle that improves life for everyone—not just those who identify as disabled.

This episode is an essential resource for quality advocates, policymakers, accreditation professionals and others committed to improving care for all. It underscores that disability is not a niche issue but something that affects nearly all of us, eventually. By accounting for disability, health care can be better and more accessible for everyone.

Key Quote:

“The reason to use words like illness and impairment is someone may have a functional limitation but not identify with the term disability. That's common in some groups, like older adults, where having some physical limitation may lead to experiences similar to someone who would identify as being disabled. But that person might not identify with the term disability.

Different people identify with different terms that underlie that same need for accommodation and access. Someone may consider themselves disabled but not have that same limitation—because of technology, the way the physical space has been built or laid out—may not actually experience that functional limitation.

So wording needs to be broad and encompassing to capture the range of experiences within the disability community.”

-Rupa Valdez, PhD

Time Stamps:

(01:46) Understanding Disability in Health Care

(03:40) Challenges in Measuring Disability Care

(07:30) Addressing Ableist Bias

(12:29) Building Better Standards and Measures for Disability Care

(18:52) Tips on Improving Care for People with Disabilities

Dive Deeper:

NCQA Health Outcomes Accreditation

HEDIS Disability Description of Membership (DDM)

Connect with Rupa Valdez

Connect with Polina Lissin

Connect with Elizabeth Ryder

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.