About this Webinar Training

Quality Improvement for Health Plan Accreditation

This course navigates customers through the most recent updates and changes to Health Plan Accreditation’s Quality Management and Improvement standards. NCQA staff and surveyors provide insights on interpreting requirements and navigating standards, and clarify misconceptions. The presenters will address scenarios, give examples of performance improvement opportunities from prior NCQA surveys, and answer questions.

What You Will Learn

Course Topics
•    Health Data Sharing Arrangements
•    Data Exchange and Usability Strategy
•    Quality Improvement Cycle
•    Identifying Opportunities for Improvement

Learning Objectives
After the course, learners will be able to:
•    Describe updates and changes to the standards and guidelines. 
•    Interpret the intent of Health Plan Accreditation requirements.
•    Describe relationships and themes across requirements.
•    Recognize requirement implications and considerations for stakeholders.
•    Define performance improvement opportunities.

Learning Outcomes
After completing this course, learners will be able to:
•    Develop and maintain evidence-based program policies and procedures.
•    Prioritize performance improvement initiatives. 
•    Implement reliable and valid practices for population health management. 

Who Should Attend

Clinicians, executives, managers, specialists, consultants, delegates, and vendors who are employed by or contract with health plans and have responsibilities related to population health management, including:

•    Accreditation or Compliance
•    Clinical Social Work
•    Population Health
•    Quality Improvement

Faculty

Joseph A. Stankaitis, MD, MPH, FACP, FAAPL

Dr. Stankaitis is the Principal for JAS Medical Management Solutions Consulting, LLC, offering support in the arenas of NCQA accreditation, Quality and Population Health programs, Care Management services, success in Value-Based Payments agreements, and in Health Plan Operations development, including the needs of special populations.

Previously Dr. Stankaitis was the Chief Medical Officer of Highmark Wholecare, serving nearly 500,000 vulnerable individuals throughout Pennsylvania through its Medicaid and D-SNP programs. Dr. Stankaitis served as the Chief Medical Officer of the Monroe Plan for Medical Care, a not-for-profit Individual Practice Association founded in 1970 to provide care for low-income and working poor individuals with over 12,000 contracted healthcare practitioners on its panel. Monroe Plan has a history of successfully assuming full-risk for up to 188,000 covered lives for Medicaid, Health and Recovery Plan, and Children’s Health Insurance products. 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. He served as the Vice President, Client Support and Education and Chief Medical Officer for Equifax Analytical Services a healthcare information services company that developed clinically astute decision support systems (claims editing and case-mix adjusted physician profiling) and a fully accredited Credentials Verification organization.

He has previously served as the Lead Medical Director for Excellus BlueCross and BlueShield’s IPA-model HMO with 600,000 members and as the clinical lead for Excellus’ Xerox Corporation’s Blue Cross Health Systems Management entity.

Other professional experiences include serving as the 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.

He holds a BS degree in Biology from Boston College, 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 having completed a residency and Chief Residency in the University of Rochester School of Medicine and Dentistry Primary Care Program in Internal Medicine.

Continuing Education

This live course grants 1.0 Continuing Education Unit (CEU) points for PCMH Certified Content Experts.

This is a non AMA PRA Category 1 Credit^TM, ANA CNE, ACPE activity.

* Please note – You must attend the entire program to be eligible for total number of contact hours.

Disclosure of Relevant Financial Relationships

The National Committee for Quality Assurance (NCQA) endorses the Standards of the Accreditation Council for Continuing Medical Education which specify that sponsors of continuing medical education activities and presenters at and planners for these activities disclose any relevant financial relationships either party might have with commercial companies whose products or services are discussed in educational presentations.

For sponsors, relevant financial relationships include large research grants, institutional agreements for joint initiatives, substantial gifts, or other relationships that benefit the institution.  For presenters or planning committee members, relevant financial relationships include the receipt of research grants from a commercial company, consultancies, honoraria, travel, or other benefits, or having a self-managed equity interest in a company; or having an immediate family member or partner with such a relationship.

Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

Relevant financial relationships exist with the following companies/organizations:

Faculty:
Joseph Stankaitis, MD

Additional Planning Committee Members:
Felicia Khaalid
Gerlad Stewart
Tandeece Mazloum-Yazdi

This program was developed in part by NCQA staff.