From Susan

Ever since the new administration began in January, we have been asked many questions about NCQA Health Equity Accreditation implications and implications for organizations that have put initiatives in place. People feel like the rug has been pulled out from under them. Uncertainty causes stress, anxiety, and sometimes depression.

For me, one of the benefits of growing older is seeing the various administrations come and go and the pendulum swinging one way and then another. At MHR, we do not talk politics with clients or each other as it can be polarizing. You should never hear a personal viewpoint from the consultants, as that is the MHR policy and position. But we deal with the implications of policy decisions, whether we agree with them or not. Our job is to help you navigate the waters and have more calmness and confidence in what you do. That is productive. Hashing over political decisions is not.

What comes next?

We already know about the policy change that deemphasizes certain diversity, equity, and inclusion standards. Other potential developments may include:

• Reduced funding from CMS for certain Medicaid and Medicare programs
• Implementation of Medicaid work requirements in some states
• Changes within HHS

We’re hearing from clients that internal resources are dwindling, with layoffs occurring in the accreditation area or with those they work with, due to changes in reimbursement. Although organizations won’t acknowledge it, the implementation of AI in processes results in fewer labor needs. Bemoaning the loss or lack of resources is not productive. Strategizing methods with the MHR consultant to maximize the resources you have is productive. That is where the vast experience level of our consultants benefits you and where they shine even brighter!

How do you do more with fewer resources?

It’s incumbent on everyone to be as efficient and resourceful as possible. We do not consult on meeting Medicare and Medicaid payment strategies, nor an organization’s overall strategy. But we do consult on how to get the most out of your dollar for NCQA accreditation requirements, maximizing the effectiveness and integrating as many standard requirements as possible into what you do.

We provide resources of guides, templates, and tools to assure that what you do does not require re-work or the possibility of missing the mark. We also write blogs that give the reader tips on maximizing how you complete your work. Our clients tell us that the blogs are frequently sent up the leadership chain to support their work and that MHR consultants are an extension of their accreditation team. Some organizations will decrease consulting dollars in times like these. It may seem self-serving, but using the consulting resources will decrease re-work and conducting needed activities correctly the first time. Time and energy are wasted so much, and it breaks our hearts when missteps could have been avoided. Penny rich, pound foolish.

An additional service that we’ve heard from clients that would be helpful is staff augmentation.

The NCQA accreditation skillset is specialized and difficult to find. Candidates can say that they have NCQA experience, but I, tongue in cheek, say that they may have been in the building when NCQA surveys occurred. One needs to tease out what exactly they know and have done with very pointed questions. We have been used frequently to assist clients with those questions and interviews to evaluate and confirm what skills candidates have. We do this internally with those we hire, and it’s tough and takes a long time. What they say and what is reality are two very different things. We feel your pain! Even with doing everything right, it’s hard to know who will shine and who will not. Since temporary assistance is a client need while looking for team members, we will be staffing up this year to provide that service to clients when needed.

We will post articles and information that we provide to consultants on our website soon, but we also want you to be able to access that resource. The better informed you are and know the broader scope of what is occurring in health care, the more valuable you are to your company. We love helping you to be successful! That tab is coming soon to our website.

As the healthcare system grapples with changing policies, reducing costs, easing complexity, and ridding the systems of administrative burden, anxiety can arise due to uncertainty, fear of what is to come, and confusion regarding how these changes could affect your NCQA accreditation.

Rest assured, MHR is here to help you navigate any change in requirements, reassess your NCQA strategy, and advise on staffing resources, training, and tools.

What can you do now?  

• Stay informed about updates from your state Medicaid agencies
• Monitor federal websites, such as Medicaid.gov and HHS.gov
• Review your quality programs
• Evaluate how changes could affect resources
• Ponder how you can maximize efficiency with the resources provided

MHR is here to help.

If you are unfamiliar or new to MHR and would like to discuss how we differ from other NCQA consulting firms, please:

• Reach out and schedule a Discovery Call.
• Review our Blogs on important NCQA topics
• Go to our Events page and listen to our past webinars
• Visit our Products page for training, tools, and templates
• Follow us on LinkedIn: my LinkedIn page and MHR’s Company page
• Send questions to [email protected]
• Monitor our emails for updates

 Please mark your calendar for our next complimentary webinar event on June 12, 2025, at 2 p.m. ET.