Quality Talks With Peggy' O'Kane: 'Systemness' is the Key to Better Quality

Quality Matters: A Podcast by NCQA

In this episode of Quality Talks With Peggy O’Kane, NCQA President Peggy O’Kane has an energizing, constructive conversation with Dr. Will Shrank, a Venture Partner at Andreessen Horowitz.

Will shares his vision for a more cohesive health care system that works based on aligned incentives, meaningful measurement of patient outcomes and savvy implementation of value-based care.

Peggy and Will discuss:

• The ‘Systemness’ Solution: Will emphasizes that while American health care has the right components—technology, talent and intent—it lacks the integration to make them work together. Systemness means aligning care delivery, data and incentives to function as a cohesive whole.
• Measurement Makeover: Current quality metrics often miss what matters most to patients and providers. Will calls for fewer, outcome-focused measures—like slowing disease progression—not just process checks. Digital measurement can help, but fragmented data remains a challenge.
• Reimagined Reimbursement Prioritizes Primary Care: Will envisions a future where primary care providers take on meaningful financial risk for the cost and quality of care. This approach could help simplify incentives, foster collaboration with specialists and drive better outcomes.
• From Waste to Wellness: Health care wastes billions of dollars on administrative complexity. Meanwhile, prevention—arguably the most cost-effective strategy—struggles to gain traction due to delayed ROI. Will argues that aligning incentives around long-term health is essential to reducing waste and improving outcomes.

Will concludes by assessing Medicare Advantage as a model of high-value care. Listen to the whole conversation for a warm, witty tour of quality’s accomplishments and prospects.

Key Quote:

We just have to make this simpler. We’ve got to make it easy for doctors to do the right thing and to create the right relationships and to set the right paths.

I think most people would agree a model where primary care docs have some meaningful accountability for the populations they serve would be better than what we have today.

And if we as a system decided that's the direction we're going to go and make that the North Star, I think we in a much shorter time could get efficient, higher quality, and deliver better outcomes at lower cost, and deliver more equitable care for all Americans.”

Will Shrank, MD

Time Stamps:

• (01:06) A Systematic Approach to a Better Future
• (04:12) Challenges in Quality Measurement
• (09:24) Payment Models and Primary Care
• (13:55) Addressing Waste
• (24:49) Medicare Advantage and Value-Based Care
• (28:43) Peggy’s Final Thoughts

Links:

Studies by Will Shrank (Google Scholar)

Connect with Will