Turning Digital Quality Measurement into a Catalyst for Health Plan Transformation

The shift to digital quality measurement is changing how health plans approach performance improvement, equity, and member experience. What once served primarily as a compliance requirement has become a vehicle for enterprise transformation, with the potential to realign operations and drive lasting improvements in care delivery.

This session, presented at the NCQA Health Innovation Summit in San Diego, CA, featured insights from leaders who have helped guide organizations through the digital quality transition. Terri Cox Glassen, MHA, enterprise quality and accreditation managing director at The Cigna Group, brings expertise in setting systemwide clinical strategy to improve outcomes, enhance patient care delivery, and secure external validation for quality programs. Daniela Simpson, MBA, senior consultant at Wakely, adds perspective from two decades of experience in healthcare analytics and data strategy across payer, provider, and consulting environments.

Together, they examined how one national health plan leveraged the digital transition to bring clinical, operational, and technology teams together under a unified framework. Central to this work was securing executive sponsorship, preparing the organization for change, and building shared ownership among leaders across functions. By redesigning workflows, clarifying roles, and embedding digital quality into everyday decisions, the plan shifted from retrospective reporting to real-time performance monitoring.

The session also outlined a scalable analytics framework built on interoperability standards, strengthened integration pathways, and aligned data infrastructure. This model enables organizations to connect systems, track progress in real time, and align technical planning with quality and business priorities.

While the digital transition presents challenges—including governance, workforce readiness, and data integration—it also offers health plans the opportunity to transform compliance into strategy.

Reference:
NCQA Health Innovation Summit. Beyond Compliance: How Digital Quality Measurement Is Powering Enterprisewide Transformation. NCQA; October 13, 2025. Accessed September 29, 2025. https://events.ncqa.org/summit2025/session/3146727/beyond-compliance-how-digital-quality-measurement-is-powering-enterprisewide-transformation