EP 518 ENCORE: Quality Without Guesswork - with Kate Grohall

We explore how reducing variation in cost, outcomes, and experience creates real value, and why deep provider metrics and real-time member support outperform box-checking credentialing. Kate Grohal shares a playbook for aligning incentives without repeating the mistakes that soured HMOs.

• defining quality as reducing variation across cost, outcomes, experience
• Kate’s path from patient escort to quality leader
• why NCQA alone falls short for measuring provider performance
• additional metrics: infection rates, readmissions, team engagement, co-management
• building value-based networks that screen out low-performing providers
• real-time care navigation via nurses, MAs, and app-based prompts
• behavior...