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“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®)
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 recognizing the disorganized state of healthcare during her early career as a respiratory therapist, O’Kane pursued a master’s degree in public health and health policy from Johns Hopkins Bloomberg School of Public Health, which equipped her with the knowledge to revolutionize healthcare quality standards.
Under her visionary leadership spanning 35 years, NCQA developed the Healthcare Effectiveness Data and Information Set (HEDIS®), now the nation’s most widely used quality measurement tool. Today, more than 216 million people—approximately 65% of the U.S. population—are enrolled in NCQA-Accredited plans that use HEDIS to assess and benchmark care quality.
O’Kane has been a passionate advocate for addressing racial inequities in healthcare outcomes, emphasizing the importance of data collection and measurement to identify and reduce disparities. Her pioneering work has established NCQA as the foremost authority in healthcare quality assessment, with more than 10,000 entities—including health plans, health systems, primary care practices, and technology vendors—accredited or recognized through NCQA’s evaluation programs.
After more than three decades of dedicated service, O’Kane has announced her retirement at the end of 2025, which coincides with NCQA’s 35th anniversary. As she prepares for this transition, she remains committed to advancing digital quality measurement and expanding NCQA’s focus to more ambitious goals in population health management and health equity.
Connect with Laurie McGraw – Inspiring Women:
