My 2 cents and 3 takeaways from Qualipalooza 2026.
1. This is a brutal year to be a quality executive.
Quality has become a revenue protection function. Stars defend the top line, and litigation risk is climbing, with FCA cases, OIG audits, and lawsuits challenging CAHPS and Star Ratings themselves. Quality performance is critical to weathering the storm. Yet ELT attention is consumed by the gaping wounds elsewhere in the business. (Great summary of this year from Ryan Peterson at Upward Growth: https://lnkd.in/gMG9-yKm)
The consequence: quality executives and vendors need to focus on immediate value. Nobody is buying 18-month roadmaps right now.
Next year won’t be easier, and CMS focus will keep evolving.
2. Measures will rotate, weights will shift, methods will sunset.
Chasing the HEDIS-measure-of-the-month is how plans end up rebuilding every year. The best approach is a quality management platform and process foundation that absorbs existing and future challenges.
3. AI talk got operational.
Less buzzword, more workflow: closing care gaps, segmenting members, moving faster from data to outreach. The winning question is no longer whether to use AI, but where it disappears into operations.
The market looks for a high-performance member engagement and activation solution, powered by AI that disappears into the workflow, easy and rapid to launch, delivering value immediately and ready for whatever CMS does next. Self-promotion warning: this is the bet we made at Twig Health.
Thank you Alison Dougan, Amy Blackledge, MBA, MSN, CSSBB, Amy Reilly MS, OTR/L, CCM, CPC, Crystal Redfern, Elya Tagar, Leigh Elko, MS, LSSGB, PMP, RRT, Ryan Peterson, Sabrina Zerzouri, MPH, Bill Rayball and many more for great chats.