Why Strive’s Dual NCQA Accreditations Help Us Provide Great Care to PatientsAuthor : Betsy Simpson, Strive Health Senior Director of Quality
You might have heard a resounding virtual high five when we learned that Strive Health had earned two simultaneous three-year accreditations for our Case Management and Population Health programs from the National Committee for Quality Assurance (NCQA), an independent, not-for-profit organization dedicated to assessing and reporting on the quality of health care related plans, organizations, and programs. In the words of Strive Health co-founder and CEO, Chris Riopelle, “getting not one, but two simultaneous accreditations is a crowning achievement for a healthcare startup.” Strive Health’s Case Management Program supports kidney patients with the most complex needs. It’s a high-touch program supported by registered nurses. The goal is to progress the patient towards self-management and into a less intensive level of care. By addressing the patient’s most immediate and intense needs, we can slow the progression of the disease so they can achieve better quality of life. The goal is to graduate them out of intensive case management and place them into our less intensive population health program.
It was the culmination of a rigorous auditing process we began in 2019. To earn it, we had to demonstrate that we had the policies, procedures and structure in place to meet the accreditation standards and guidelines. We had to show that we could support the ongoing analysis of our programs and that those programs were effective at delivering quality in everything we do.
Two programs, one goal
Strive Health’s Case Management Program supports kidney patients with the most complex needs. It’s a high-touch program supported by registered nurses. The goal is to progress the patient towards self-management and into a less intensive level of care. By addressing the patient’s most immediate and intense needs, we can slow the progression of the disease so they can achieve better quality of life. The goal is to graduate them out of intensive case management and place them into our less intensive population health program.
One of the biggest challenges in healthcare is care coordination. How do we get patients from one point to another without adding to their already high level of stress? Our case managers help patients learn how to address their concerns, and provide high-touch clinical care and resource coordination including hospital admissions and other needed services. Then we develop a goal-oriented, personalized care plan. By coordinating continuity of care across multiple providers, we can improve their ability to self-manage.
We also look at social determinants of health that may be barriers to optimal outcomes. Which activities of daily living can we address? Our case managers look beyond clinical care to psycho-social and socioeconomic issues. Then we can refer patients to our other programs depending on their needs. If someone needs help with transportation to get to medical appointments, we help them. If they are struggling with behavioral health issues, we connect them with our social workers.
Our case managers are patient advocates. Our goal is to help patients avoid the stress of figuring out how to navigate the system. Each care plan is individualized for their needs. The focus is on patient centered goals – what do they want to work on? If they’re making progress in the areas important to them, that’s a really great step towards self-management and that sense of accomplishment helps keep them motivated.
Population Health addresses the entire population of patients through all complexities. All interventions may not be appropriate for all patients. Some may not need a lot of clinical support; they just need ongoing education. Others have more complex needs. Our Care Team is the core of our Population Health program. We help health systems, nephrologists and payors look at the entire spectrum of care to see how we can improve outcomes and lower costs.
Population Health reviews where each patient is in their care journey, then helps them make informed decisions about what type of support they need moving forward. The goal is to prevent patients from crashing into dialysis and instead develop a care plan to manage their progression so they can pick the modality they want for dialysis when it’s time. For patients in dialysis, we work together with their nephrologist to help them navigate that process. For example, we know that home dialysis can improve their quality of life, so we want to make sure this population understands all the options available to them.
The goal of both these accredited programs is to ensure there’s a continuity of care. We partner with nephrologists to provide an extended care team that supports patients with everything they need.
We are beyond excited about our dual NCQA accreditation, but our commitment does not take a break in between our accreditation cycles. We will continue to maintain compliance with all NCQA requirements throughout the next three years. We will collect data, seek out and implement quality improvement opportunities, and continue to innovate new ways to improve outcomes and lower costs for patients facing chronic and end-stage kidney disease.
We started Strive to transform the way we think about and deliver kidney care. We combine compassionate care teams with predictive analytics to identify patients earlier, before the disease progresses, so we can work together with providers and payors to get them the support they need to improve their quality of life. That’s our passion, that’s our mission. We did pause briefly for that virtual high five, but we can’t wait to get back to work. Nobody here is resting on our laurels.