Introduction to Health Plan Accreditation for MVP Health Care
This intense three-day seminar is designed for organizations undergoing their first NCQA survey, those that have new staff managing the survey process or those who need a refresher. Participants will learn about the comprehensive framework to improve the quality of care and services through NCQA's Accreditation process.
Participants are encouraged to purchase a copy of the 2020 Health Plan Standards and Guidelines to complement the seminar’s material.
The training materials for the NCQA Health Plan Accreditation training will be sent to you electronically on January 28, 2020. If you prefer a hard copy of the training materials, please print them and bring them with you to the training session. Hard copy versions of the training material will not be available at the training.
Target Audience
This program is geared towards individuals responsible for preparing their organization to go through NCQA Health Plan Accreditation, including (but not limited to):
- Quality Improvement/Coordinators/Managers/Directors
- Quality Assurance Managers/Directors
- Clinical Outcomes Managers/Directors
- Consultants
- Accreditation Managers
Learning Objectives
- Explain the rationale for each of the standards.
- Apply the accreditation requirements to measure the quality of services and processes.
- Assess clinical quality through the use of HEDIS measures.
- Prepare for the NCQA Accreditation survey process.
Ann Carson, MPH
Ann F. Carson is Director, Training and Performance Consistency, on NCQA’s Policy team. She is responsible for all new and ongoing surveyor training, and for assessing and improving surveyor performance. She also manages NCQA’s Reconsideration process, participates in standard development and maintenance and is faculty for several NCQA Education programs.
Prior to her role as director, Ann was senior staff on NCQA’s Accreditation team, where she led PHQ product operations and the first phase of NCQA’s next-generation accreditation review software system. From March 2000–October 2008, she was assistant vice president, Product Development, where she led the development and revision of NCQA evaluation programs, including:
- Wellness and Health Promotion Accreditation.
- Physician and Hospital Quality Certification.
- 2008 Accreditation for Health Plans, which expanded to include HEDIS for PPOs.
- 2001–2004 Accreditation business process redesign, which included development and implementation of the Web-based Interactive Survey System across all products.
- Annual revisions to all accreditation/certification standards.
Ann earned her BA from Williams College and her MPH from Johns Hopkins University.
Clint Koenig, MD, MA, MSPH
Clint Koenig, MD, MA, MSPH is the senior Medical Director at OhioHealthy, a new system-based health plan in Columbus Ohio. He has served as State Medical Director in New Hampshire and Ohio. Other leadership roles include the Health Plan Regional Chief Medical Officer at Universal American, a government programs health management organization in Syracuse New York as well as the Director for Utilization Management at Monroe Plan for Medical Care, a healthcare management organization in Rochester, New York. In addition, Clint held Chief Medical Officer roles in Federally Qualified Health Centers and integrated delivery systems.
He has been an NCQA surveyor for 10 years and surveys health plans, Patient Centered Medical Home, Special Needs Plans and Long Term Services and Supports organizations.
Dr. Koenig received his MD from Albany Medical College in Albany, NY. He completed his residency in Family Medicine, from the University of Missouri. He also completed a fellowship at the University of Missouri, where he received Masters degrees in Public Health and Journalism.
Veronica Locke, MHSA
Veronica Locke is a consultant for The Mihalik Group, providing healthcare-related consulting services. Her areas of expertise include quality assessment and improvement; credentialing; delegation; disease management accreditation/certification; population health management; multicultural health care.
Veronica is the former Senior Manager of Accreditation Policy for the National Committee for Quality Assurance. She was actively involved in the development and maintenance of the standards and guidelines of NCQA's Accreditation and Certification programs, specifically Health Plan, Disease Management and Multicultural Health Care Distinction programs. As a member of the Policy team, one of her major responsibilities was to serve as a content champion when providing policy clarifications and trainings internally and externally.
She received her Bachelor of Science Degree in Public Health from the University of Maryland, College Park and her Master of Health Systems Administration Degree from Georgetown University in Washington, DC.
In support of improving patient care, the National Committee for Quality Assurance is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC), the American Academy of Physician Assistants (AAPA), the American Psychological Association (APA), and the Association of Social Work Boards (ASWB) to provide Interprofessional Continuing Education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 15.50 Interprofessional Continuing Education (IPCE) credit for learning and change.
This educational activity is approved for: 15.50 AMA PRA Category 1 CreditTM, ANA CNE, APA, ACPE and ASWB ACE.
This program is sponsored by The National Committee for Quality Assurance. The National Committee for Quality Assurance is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Provider of continuing pharmacy education. The assigned universal program number(s): JA0004597-0000-20-005-L04-P. This program provides 15.50 CPE contact hours.
Upon successful completion of this program (attending the full session and completing a program evaluation), participants will access CPE Monitor on the ACPE website to locate and track their CPE statement of credit.
* Please note – You must attend the entire program to be eligible for total number of contact hours.
Available Credit
- 15.50 AAPA
- 15.50 ACPE
- 15.50 AMA PRA Category 1 Credit™
- 15.50 ANCC
- 15.50 APA
- 15.50 ASWB
- 15.50 IPCE
- 1.00 Participation