Quality Matters: A Podcast by NCQA

Credentialing rarely makes headlines, but it plays a critical role in determining how quickly patients can access care, how providers join health plan networks, and how healthcare organizations maintain quality at scale. In this episode of Quality Matters, host Tsveta Polhemus examines why credentialing has become one of the most important foundations for modern healthcare delivery—especially as virtual care continues expanding across states and specialties. Joining the conversation are Sharon Meers, President and Co-Founder of Midi Health, and Greg Smith, Director of Operations at Evernorth Health Services. Together, they explore how credentialing impacts providers, payers, and patients alike, and why standardized, trusted processes are essential for improving access while maintaining confidence in care. Sharon shares Midi Health's remarkable growth from approximately 20 clinicians to nearly 800 providers serving patients nationwide. As the organization rapidly expanded across all 50 states, credentialing and payer enrollment became one of its greatest operational challenges. She explains how achieving NCQA Credentialing Accreditation enabled delegated credentialing with major national payers, reducing enrollment timelines from months to just days and allowing patients to access care sooner. Greg offers the payer perspective, discussing how credentialing supports network adequacy, strengthens audit readiness, and creates greater consistency across provider networks. He explains why recognized standards help reduce administrative friction while giving health plans greater confidence in the organizations they partner with. The episode concludes with a Patient Voice segment featuring Carroll Schreibman, who shares her experience navigating perimenopause symptoms after years of searching for answers. She reflects on how quickly accessing virtual care through Midi Health transformed her health, work, and quality of life—and why listening to patients remains central to delivering meaningful care. As healthcare delivery continues evolving, one message becomes clear: credentialing isn't simply a compliance exercise. It's the infrastructure that enables trusted, timely, and equitable access to quality care. Highlights Credentialing Enables Access Credentialing determines how quickly providers can begin seeing patients, making it one of the most important drivers of timely access to care. Scaling Virtual Care Responsibly Midi Health shares how standardized credentialing supported rapid national expansion while maintaining consistency and quality. Trusted Standards Build Confidence NCQA Credentialing Accreditation creates a common framework that strengthens relationships between providers, payers, and patients. The Payer Perspective Credentialing helps health plans improve network adequacy, streamline oversight, and reduce administrative burden while supporting quality care. A Patient's Experience Carroll Schreibman shares how timely virtual access to menopause care helped restore her quality of life after years of unanswered questions.     Key Quote "Credentialing isn't just a compliance requirement—it's the infrastructure that makes timely, trusted, high-quality care possible." — Sharon Meers     Time Stamps - Waiting on Final File (00:00) Why Credentialing Matters More Than Ever (01:52) Meet Sharon Meers & Greg Smith (05:43) A Patient's Journey to Virtual Care (09:25) Credentialing 101: Why It Matters (12:12) How Delegated Credentialing Improves Access (14:36) Scaling Midi Health from 20 to 800 Clinicians (18:00) Balancing Speed, Quality, and Trust (24:44) Measuring Patient Access and Outcomes (28:47) The Future of Credentialing and Virtual Care (33:25) Patient Voice: Carroll Schreibman's Story (42:47) Key Takeaways and Closing Thoughts     Links & Resources NCQA Credentialing Accreditation Learn more about Midi Health Learn more about Evernorth Health Services Connect with Sharon Meers Connect with Greg Smith Connect with Carroll Schreibman Connect with Tsveta Polhemus Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This episode of Quality Matters examines the growing role of digital wellness and chronic condition management programs and the challenge of measuring what truly matters. Host Rachel Harrington is joined by Peter Robertson of the Purchasing Business Group on Health and California Quality Collaborative and Kevin Masci of Omada Health to discuss how digital health solutions can help address rising healthcare costs, workforce shortages and fragmented care experiences. Peter and Kevin explain why meaningful engagement goes far beyond app downloads and login counts. Instead, successful programs focus on sustained participation, patient-centered goal setting, integration with primary care and measurable improvements in health outcomes. The conversation explores how employers, health plans and providers are evaluating digital solutions through clinical outcomes, patient-reported outcomes, utilization measures and value-based contracting arrangements. The guests also discuss one of the most important challenges facing digital health: trust. Privacy, transparency, data security and clear communication about how patient data is collected and used all play critical roles in long-term adoption. The episode concludes with a Patient Voice segment featuring Brandee Hicks, who shares her firsthand experiences using digital health tools, highlighting both the convenience they offer and the ongoing challenges around interoperability, digital literacy and maintaining support after programs end.     Highlights Beyond Logins and Clicks Meaningful engagement isn't about how often patients open an app. It’s about helping people achieve their health goals through sustained participation and measurable outcomes. Measuring What Matters Guests discuss the growing use of clinical outcomes, patient-reported outcomes, utilization data and value-based contracting to assess digital health program performance. Trust Is Essential Digital health solutions must address concerns around privacy, transparency, data security and how patient information is stored and shared. The Patient Perspective Brandee Hicks shares how digital tools can improve organization, access and self-management while also revealing gaps in continuity, support and interoperability. Looking Ahead The future of digital health depends on better integration with primary care, more personalized engagement strategies and stronger measurement frameworks that prioritize patient outcomes.     Key Quote: "If we're really serious about improving health outcomes, we have to move beyond measuring clicks and logins. The real question is whether people are achieving meaningful progress toward their health goals—and whether these programs are creating lasting value for patients, providers and purchasers alike." — Kevin Masci     Time Stamps: (02:20) Meet Peter Robertson (03:45) Meet Kevin Masci (05:53) Why Digital Solutions Matter (10:01) Care Coordination, Not Care Fragmentation (11:52) Defining Meaningful Patient Engagement (15:07) Why Consistent Measurement Matters (18:32) Measuring Outcomes in Value-Based Contracts (21:12) Data Stratification, Risk Adjustment and Performance Guarantees (27:22) Privacy, Trust and Transparency in Digital Health (30:44) The Future of Digital Wellness and Chronic Care Management (35:08) Patient Voice: Brandee Hicks (40:25) Patient Challenges, Access and Continuity of Care (45:23) Key Takeaways and Closing Thoughts     Dive Deeper: Connect with Peter Robertson Connect with Kevin Masci Connect with Brandee Hicks Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.