The future of quality measurement is coming into focus, and at Qualipalooza, NCQA offered a look into what comes next. As the industry moves toward digital quality measurement, NCQA outlined how Medicare Advantage and Stars leaders can begin building the capabilities needed to thrive in a more connected, data-driven environment. NCQA also reaffirmed its commitment to the 2029 timeline for retiring hybrid measures and explained the logic behind the decision.
In a keynote conversation moderated by Melissa Newton Smith, founder and senior advisor at Newton Smith Group, two NCQA leaders walked the room through the shift. Tricia Elliott, Vice President of Quality Implementation, brought the content and measure perspective. Marlene McIntyre, Assistant Vice President of Digital Solutions, brought the product and data view. Chairperson Sy Zahedi opened the morning with a reminder that's landing harder every season: when CMS changes the rules, your structure has to change with them.
The Current State
Fragmented data across systems and care settings constrains quality measurement today. This makes it difficult to gain a complete picture of care delivery in real time and limits opportunities to intervene before issues arise. NCQA's digital quality strategy aims to address these challenges by creating a more streamlined, standardized approach to data collection and measurement. Elliott described data fragmentation as a key challenge that NCQA is working to solve.
McIntyre framed the transition as more than a technology upgrade. Digitizing the same manual processes would shift the fragmentation, friction, and burden from one place to another. The goal is trusted, validated, standardized data arriving early enough to act on. If organizations get reliable signals sooner, quality stops being a once-a-year reporting exercise and starts shaping care in the moment.
The reframe carried the session: measurement moves from compliance to enablement.
The Hybrid Measures Timeline
While the plan to retire hybrid measures by 2029 remains unchanged, individual measures, such as Transitions of Care, may move between 2028 and 2029 as NCQA works through the challenges of bringing certain data, including survey measures and patient-reported measures, into the digital space.
Elliott pointed out that this approach is aligned with federal and state policy direction. She also highlighted positive signals that enable confidence in the transition: broader adoption of HL7 FHIR and APIs, heavy industry investment in interoperability, and alignment around standards like FHIR and CQL driven by CMS. At the same time, regulators, providers, health plans, and patients are all seeking more timely, useful health information, creating momentum across the healthcare ecosystem.
Advice for Plans and MA Stakeholders
Quality no longer belongs in a silo. Success depends on a true shared capability across the business, with quality still steering, but technology, operations, care management, and analytics all at the table. McIntyre called for a single accountability owner paired with clearly defined roles for every contributing department, captured in a living document the group agrees on.
Elliott highlighted the evolving role of quality professionals and reinforced that their expertise is essential. Digital measurement frees teams from labor-intensive activities, like chart chasing and manual validation, toward higher-value work: catching care gaps earlier, reducing false gaps, sending care management teams after the wrong members, and acting on data instead of assembling records.
Participants shared concerns about rural and small providers that continue to rely on paper-based processes with limited or no digital infrastructure. Speakers acknowledged the risk of widening the gap for underserved communities and pointed to shared payer-provider partnerships, policy advocacy, and grant and government funding as part of the answer, while conceding there is no single fix.
AI ran through the discussion as an accelerator. Plans on the follow-up panel described using available tools to build member personas, run propensity models, and prioritize outreach, bringing together claims, appeals, grievances, social factors, and call-center sentiment to understand the member before the intervention.
The Through Line: Start and Learn
NCQA encouraged organizations to replace a "wait and see" mindset with a "start and learn" approach. McIntyre encouraged plans still watching from the sidelines to get started now, emphasizing that the transition is already in motion, standards are maturing, and early adopters are building capabilities that will keep compounding.
Questions Worth Carrying Forward
Elliott left the room with three reflections framed as questions a plan should answer first: What data do we have today? How usable is the data? What validation have we run? The foundational data-quality assessment, she said, points to where to start.
For Medicare Advantage quality leaders, those questions spark even more: Who in your organization owns the digital quality transition, and is the ownership shared across IT, operations, and care management? Does your quality function still sit off to the side rather than inside clinical and care management workflows? Which of your contracted providers and vendors are ready, and what is your plan for those who are not?
These are the conversations Qualipalooza is built for. The questions Elliott and McIntyre raised on data governance, measuring readiness, the workforce shift, and the rural divide run straight into the sessions and peer exchanges across the RISE quality and Stars community. The path forward is becoming clearer: organizations that begin learning today will be well positioned to lead tomorrow.
Continue the conversation at RISE West, and compare notes with the plans already building for 2029.