The North Carolina State Transformation Collaborative (NC STC) is a public-private partnership designed to advance value-based and person-centered care through multi-stakeholder alignment, with federal engagement (CMS) and state leadership (NCDHHS).

North Carolina is one of four states—along with Colorado, California, and Arkansas—selected to participate in this initiative operated by the Health Care Payment Learning & Action Network (LAN).



Duke-Margolis, in partnership with the NCDHHS Division of Health Benefits and the LAN, is establishing technical working groups and gathering strategic feedback to build a path forward to advance the NC STC goals across key priority areas: aligning quality measurement, strengthening coordinated and accountable primary care, enhancing health equity data, and improving data exchange.

Welcome to the first quarterly NC STC newsletter. These newsletters will keep you updated on STC activities and provide you with related resources and opportunities.

As described at the NC STC Launch Event in February 2023, Duke-Margolis is convening multi-stakeholder technical working groups to advance NC STC goals. The HCT Workgroup, with a focus on performance measurement and health equity data, is the first working group to be convened as part of the NC STC.

This technical working group includes participants from clinically integrated networks, NC Medicaid prepaid health plans, health systems, commercial payers/purchasers, provider associations, the NC Health Information Exchange, and NC Medicaid. These participants, representing a variety of perspectives, were originally brought together based on their technical expertise to provide input on Medicaid transformation initiatives, and are now being reconvened as a NC STC working group.

NCDHHS reminded the Workgroup about the recently-released and updated North Carolina Quality Strategy.

The Workgroup engaged in foundational conversations, including:

A discussion about the proposed goals of the Workgroup:

• Focus efforts to improve health outcomes overall and within specific sub-populations.
• Reduce administrative burden through a focus on provider-level measures.
• Accelerate progress on advanced primary care model implementation and data sharing.
• Enable consistent health disparities measurement and identification.

and

Additional discussions on topics such as:

• What are lessons learned from previous and/or ongoing alignment efforts?
• What do we mean when we refer to health equity performance measurement: stratification of existing measures, disparities-sensitive measures, something else?
• How should we track progress on alignment and reduction of disparities in the state?
• How can we assess the impact of aligned primary care and health equity performance measures on movement to advanced primary care models?
• How will we know we have been successful? How can we measure and track measure alignment and disparities reduction in the state?

During the meeting, Workgroup members raised important issues such as:

• The need to carefully evaluate and identify the specific aspects of the measurement process that cause measurement-related burden, because variation exists not just in measure section, but also in measure implementation and reporting requirements..
• The importance of considering rural context and independent providers in these efforts, including the need to focus on measures that can be easily implemented across a variety of electronic health record systems.
• The role of quality measurement in improving health, ensuring the group is thinking through big questions about selecting measures that matter in the context of ensuring access to and continuity of care.

• Curating a prioritized set of measures and developing a pathway for aligned measurement processes with a plan for tracking progress on adoption, burden reduction, and disparities reduction
• Identifying needed data infrastructure to support improvements on performance measures and health disparities.
• Convening additional HCT Workgroup meetings to refine performance measurement priorities and actions.

Next quarterly newsletter coming in late summer/early fall 2023!

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In these discussions, “alignment” is defined to mean the application of evidence and experience to assess and identify measures, administrative components, and data that would be impactful and practical for potential use to improve performance in the provision of value-based health care. These measures, components, and data concepts, combined with evidence, will be made available to the public as a resource for consideration and use by any interested stakeholders to further the Workgroup’s goals of reducing complexity for clinicians and advancing high-quality care for all patients.