Better Primary, Behavioral and Community-Based Diabetes Care

September 6, 2022 · Andy Reynolds

A new NCQA researcher honors the legacy of a longtime NCQA leader by researching topics that will shape the future of quality and health equity.

Portia Buchongo, who joined NCQA in August as a Phyllis Torda Health Care Quality and Equity Fellow, was inspired to join the health care quality movement when she was intensive care bedside nurse. It was the late-2000s. Events and conditions that should never happen in-hospital were a national focus.

Portia approached her supervisor about creating a designated team to turn patients in their beds and help prevent pressure ulcers. “It was a really good model that evolved to support delivering good care,” she reports. The experience set Portia on a self-guided path to learn about health care quality.

• “I got really interested in what was going on at the system level,” she says. A particular interest was why so many ICU patients wound up back there a second, or even a third time.
• Her research led her to discover NCQA, our Patient-Centered Medical Home model and a passion for public health.
• From a Master’s degree internship with the Georgia Department of Public Health, to a fellowship at the CDC and an internship with an accountable care organization, she says, “My path was becoming clear and focused.”

Integrating Behavioral and Primary Care

Portia’s path has come full circle, to NCQA and the Torda Fellowship.

The fellowship is a training ground for quality leaders from diverse backgrounds. Fellows spend a year with NCQA, contributing to our ongoing research and working on projects critical to health care quality and equity. They are mentored by NCQA senior staff and have access to NCQA-led educational programs.

The Torda Fellowship celebrates the life and work of Phyllis Torda, a longtime leader and mentor to many at NCQA from 1995–2015.

Initially, Portia is working with Eric Schneider, NCQA Executive Vice President for Quality Measurement and Research, to advance quality measures for integrated behavioral and primary health care. Portia leads the multi-stakeholder panel tasked with prioritizing the quality measures and concepts.

• Funding for the project comes from the California Health Care Foundation.
  (CHCF is a frequent and long-term partner of NCQA.)
• Part of California’s CalAIM initiative hinges on a whole-person care approach to expand behavioral health access.

“One thing our recent pandemic has shown is the need for behavioral health services is incredible. Unfortunately, there are just not enough providers to meet the demand,” laments Portia.

But, she says, initiatives like the CHCF project can help promote integration of behavioral and primary health care. “Having discussions around quality will help push that forward,” she says. Also, she points out that, the outcome of this work will help states besides California.

Studying Communities and Diabetes

Beyond the CHCF project, Portia will spend her year as a Torda Fellow focused on a project that she hopes will encourage integrating social supports into primary care. Portia will study the relationship between neighborhood socioeconomic conditions and access to diabetes prevention strategies.

Her vision — cross-sector partnerships between health systems, public health and community-based organizations that incorporate social supports in health care delivery — “bridges the community,” she says.

Moreover, her work aims to identify barriers, such as:

• Food insecurity.
• Area deprivation indices.

“I’m looking at neighborhood socioeconomic characteristics at the population level that might actually be closing access to the diabetes prevention program.”

Portia says she hopes her work sheds light on factors beyond lifestyle that can make a difference in diabetes prevention.

Similar to the CalAIM initiative, Portia’s diabetes project leans on existing community resources to achieve its goals. “It creates opportunities to be more invested in community-clinical linkages,” she says, “It inspires a lot of creativity and ingenuity in how we look at social needs and how we deliver preventative care.”

Addendum
In April 2023, Portia concluded her Torda Fellowship and continued full-time with NCQA as an Applied Research Scientist, Health Equity. Congratulations, Portia!