Health Plan Accreditation: 2025 Updates Self-paced -

About

Self-paced
Expires June 30, 2026

The courses in this series will focus on taking a deep dive into all of the relevant updates for the newly released 2025 standards.

About this Self-paced Series

NCQA Health Plan Accreditation: 2025 Updates Self-paced Series

NCQA Health Plan Accreditation is the only program in the industry that bases results on clinical performance and consumer experience (HEDIS® and CAHPS®). These courses will focus on taking a deep dive into all of the relevant updates for the newly released 2025 standards. Our experienced presenters will provide learners insight to interpret the requirements, navigate the standards, and avoid misconceptions. In addition to answering live questions, presenters address generalized scenarios and provide examples based on performance improvement opportunities from prior NCQA surveys.

Please note: These courses present information based on Health Plan Accreditation 2025 standard requirements that are released in July 2024. The scope of these courses apply directly to NCQA Accreditation Surveys conducted between July 1, 2025 and June 30, 2026.

Course Resources

Presentation slides.
Recording of live session.
Scenarios for applied learning.
NCQA surveyor's perspective of the standards.
IPCE Credits for physicians, nurses and pharmacists.

What You Will Learn

Understand the 2025 updates and changes to the standards and requirements.
Interpret the intent of HPA requirements.
Describe relationships and themes across the standards.
Recognize requirement implications and considerations for stakeholders.
Define performance improvement opportunities.

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).

Who Should Attend

Clinicians, executives, managers, specialists, delegates, and vendors who are employed or contracted by health plans with responsibilities pertaining to the scope of work listed below:

Health care professional.
Health decision maker.
Consultant.
Health plan.
Health Systems
Population health organization

Live Dates

Network Management - Recorded on October 1, 2024
Individual Cost: $349

Member Experience - Recorded on October 3, 2024
Individual Cost: $349

Quality Improvement - Recorded on October 9, 2024
Individual Cost: $349

Delegation - October 17, 2024
Individual Cost: $395

Utilization Management - Recorded on October 22, 2024
Individual Cost: $395

Population Health - Recorded on October 24, 2024
Individual Cost: $349

Credentialing - Recording on November 13, 2024
Individual Cost: $395

Faculty

Kimberly Carpenter Petit, MBA, BS

Kimberly Carpenter Petit’s career began in sales, consulting, and operations at a medical device company then transitioned to a national health plan with broad responsibilities for quality management, credentialing, delegation, accreditation, HEDIS, and regulatory compliance. During this time, she gained expertise in NCQA accreditation and became an NCQA Surveyor in 2009. Kimberly joined Managed Healthcare Resources in 2017 as a Healthcare Consultant.

Kim’s early career was at NeuroMed Services Inc. in various sales, consulting, and operation roles. After three years, she learned her love for quality and began consulting with same-day surgery centers on AAAHC accreditation.

In 2001 Kim moved to Aetna where she held progressive roles through 2016. Starting in quality management at a regional level, her role expanded several times up to nationwide responsibility for accreditation, HEDIS, regulatory/compliance, quality, credentialing, and delegation.

Most recently Kim was the Sr. Director, Head of QM Program, Accreditation, Credentialing, and Delegated Credentialing for all Commercial, Medicare, and Exchange product lines across Aetna, Coventry and Joint Ventures. In this role, she set strategy and executed the National Quality Program to meet regulatory requirements and maintain NCQA accreditation.

In 2017 Kim began consulting on NCQA preparation, drawing from her numerous and varied accreditation experiences. She successfully guided many organizations through preparing and achieving NCQA Accreditation and Certification.

Kim earned her Master of Business Administration from the Kellstadt Graduate School of Business at DePaul University where she is an adjunct professor teaching a graduate course in Health Technology, Informatics & Quality, a Health Insurance Industry Perspective. Kim received her Bachelor of Science from the University of Illinois, Champaign-Urbana.

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.

Clint Koenig, MD, MSPH, MA

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, New York. 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 a master’s degree in Public Health and Journalism.

Continuing Education

The Credits listed below will be provided at the individual Course Level.

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.

Health Plan Accreditation 2025 Updates: Network Management

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 a maximum of 3.0 AMA PRA Category 1 Credit™, 3.0 Nursing contact hours and 3.0 ACPE contact hours.

The assigned universal program number: JA0004597-0000-24-013-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.