OnDemand Explaining HPA 2023:Quality Mgmt & Improvement (QI)
OnDemand Explaining Health Plan Accreditation 2023: Quality Management & Improvement (QI)
NCQA Health Plan Accreditation is the only program in the industry that bases results on clinical performance and consumer experience (HEDIS® and CAHPS®).
This OnDemand, multi-day course leads participants through an end-to-end examination of the Health Plan Accreditation standards for Quality Management & Improvement (QI). Through this course, faculty provides participants with insight to interpret the requirements, navigate the standards, and avoid misconceptions. In addition to answering live questions from participants, faculty addresses scenarios and examples based on performance improvement opportunities from prior NCQA surveys.
Please note: This course presents information based on Health Plan Accreditation 2023 standard requirements that are released in July 2022. The scope of this course applies directly to NCQA Accreditation Surveys conducted between July 1, 2023 and June 30, 2024.
To inquire about group training rates, complete our online form.
- Planning, evaluating and controlling QI interventions.
- Incorporating contracted practitioners and providers into QI.
- Coordinating care across the network.
- Measuring effectiveness of QI interventions.
- Presentation slides.
- Recording of live session.
- Scenarios for applied learning.
- NCQA surveyor's perspective of the standards.
- IPCE Credits for physicians, nurses and pharmacists.
Clinicians, executives, managers, specialists, consultants, delegates and vendors who are employed or contracted by health plans with responsibilities pertaining to the scope of work listed below:
- Case Management.
- Compliance or Risk Management.
- Population Health Management of Public Health.
- Quality Assurance/Improvement or Performance Management.
- Contracts Management.
- Health Information Systems.
At the conclusion of this course, learners will be able to:
- Interpret the intent of Health Plan Accreditation requirements for QI Standards.
- Describe relationships and themes across QI Standards.
- Recognize requirement implications and considerations for stakeholders.
- Define performance improvement opportunities.
By achieving these learning objectives, participants may experience the following operational efficacies as three to nine month post-participation outcomes:
- Increased productivity in prioritizing and planning interventions.
- Improved practices in monitoring issues and risks.
- Enhanced coordination in cross-functional efforts.
- Refined tactics in monitoring performance.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
Irv Koehler, RN, MBA, CPHQ, CPC
Irv Koehler is a health care quality consultant for the Koehler Quality Group, LLC. In this position, he is an NCQA administrative surveyor and provides consulting services to organizations evaluating and preparing for NCQA Accreditation/ Certification projects, risk adjustment validation for managed care organizations, education on quality improvement practices and outcome measure development and tracking.
Mr. Koehler is also a registered nurse with active licensure in Florida and Tennessee, and certification in quality and medical coding. Previously, he was a quality improvement professional at AmeriHealth Caritas and BlueCross BlueShield of Tennessee.
Mr. Koehler has an MBA from the Florida Institute of Technology, a BS in Nursing from Florida Southern College, a BA in Psychology and an ADN from Purdue University.
Joseph Stankaitis, MD, MPH
Dr. Stankaitis is Chief Medical Officer of Highmark Wholecare. Prior to arriving at Highmark Wholecare, he was Chief Medical Officer of the Monroe Plan for Medical Care. During 2021 and early 2022, in response to the COVID-19 pandemic, he also served as a part-time Deputy Commissioner of Public Health for Monroe County (New York).
Before joining Monroe Plan, Dr. Stankaitis was Vice President, Client Support and Education and Chief Medical Officer for Equifax Analytical Services. He previously served as Lead Medical Director for Excellus BlueCross and BlueShield’s IPA-model HMO, and as the clinical lead for Excellus’ Xerox Corporation’s Blue Cross Health Systems Management entity.
Other professional experiences include serving as Physician Advisor to the HMO Group, a national consortium of staff and group model HMOs; and prior to that, as Co-Director of the Internal Medicine Division and Head of Community Medicine, The Genesee Hospital in Rochester, NY.
Dr. Stankaitis holds a BS degree in Biology from Boston College, an MD from the University of Connecticut School of Medicine and an MPH in Health Policy and Management from the Harvard TH Chan School of Public Health. He is board certified in Internal Medicine.
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) to provide Interprofessional Continuing Education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 3.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
This educational activity is approved for: 3.0 AMA PRA Category 1 CreditTM and ACPE.
This educational activity is approved for 3.0 nursing contact hours.*
The assigned universal program number: JA0004597-0000-22-039-H04-P. 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.
This live course grants 2.0 Continuing Education Unit (CEU) points for PCMH Certified Content Experts.
* Please note – You must attend the entire program to be eligible for total number of contact hours.
NABP Credit Reporting
If you are a pharmacist completing a course offering CPE credits, please notify NCQA through ncqa.org within 14 calendar days that you have completed a CPE course. You must provide the title of the course, your NABP identification number and your DOB (month/date) within the notification to NCQA. We also recommend you update your education.ncqa.org profile with your NABP identification number.
- 3.00 ACPE
- 3.00 AMA PRA Category 1 Credit™
- 3.00 ANCC
- 3.00 IPCE
- 1.00 Participation
- 2.00 PCMH CCE