Beyond Quality

Dr. Dave Williams, improvement scientist and author who led improvement science work at IHI, outlines system-level thinking and how to treat quality as an organizational strategy. He contrasts project fixes with system-wide approaches. He emphasizes testing before scaling, mapping interdependencies, using small rapid learning cycles, and leaders owning outcomes rather than delegating them.

In the first episode of Beyond Quality, host Rex Wallace and co-host Nate Lucena welcome actuary Eve Anderson, Director of Actuarial Services at Zing Health, for a candid conversation about quality as a financial strategy in Medicare Advantage. Eve unpacks the difficult cycle smaller MA plans face, offering rich benefits they can't afford while struggling to achieve the Star Ratings that would fund them, and explains why there's no shortcut to four or five stars. The trio digs into why measuring ROI for quality initiatives is so challenging, how organizations can build stronger financial cases for quality investments, and what it looks like to align long-term financial goals with quality performance targets. Eve also offers practical guidance for quality leaders who need to communicate more effectively with finance and executive teams, and shares a candid take on the limitations of CAHPS as a measurement tool.