About this Learning Activity

Accreditation 201: Preparation and Self-Assessment

Teams that recognize gaps between their current state and the target future state are positioned to pursue NCQA Accreditation with minimal burden. Through this learning activity, professionals are equipped with a variety of resources that help teams achieve optimal preparation for NCQA Accreditation surveys. Furthermore, this course is appropriate for any health plan staff member or third-party contributor with a stake in NCQA Accreditation

What You Will Learn

Learning  Objectives

By participating within this learning activity, learners will:

• Techniques for conducting a self-assessment.
• Indicators for survey application readiness.
• Strategies for engaging stakeholders.
• Tactics for ensuring preparation activities are timely. 

Learning  Outcomes  

By completing this learning activity, learners will be able to:

• Pinpoint operational gaps and opportunities for survey preparation.
• Define work activities necessary for staff guidance.
• Develop milestones for timely advancement towards NCQA accreditation.
• Recognize practices for reducing operational burden. 

LEARNING MATERIALS AND RESOURCES

• An Interactive Self-Assessment Tool
• Presenter Slides
• Recorded Lectures
• Scenarios and Examples
• Quiz

Who Should Attend

• Executives, supervisors, and coordinators at health plans and managed care organizations.
• Professionals in compliance, public policy, and risk management.
• Professionals in performance measurement, quality assurance, or quality improvement.
• Consultants, contractors, delegates, vendors, and partners of health plans

Faculty

Kimberly Walters

Kim Walters is the Assistant Director of Accreditation Operations at NCQA. In this role, Kim leads a multifunctional team to ensure Accreditation-seeking organizations are progressing through NCQA workflows in a complaint manner. With over 20 years experience in business analysis and enterprise planning, Kim brings a comprehensive approach to systems management and performance improvement. She holds a Bachelor of Science from Indiana University of Pennsylvania.

Vince Pereira, MHA

Vince Pereira is a Senior Program Manager of Customer Education at NCQA. In this role, Vince is leads cross-functional teams in the development and delivery of resources for Accreditation seeking organizations. Prior to NCQA, Vince has served in performance improvement roles with the Veterans Health Administration and the Department of Health and Human Services. He holds a Master of Health Administration from George Mason University. 

Tammy MacDonald, MPH

Tammy MacDonald is a seasoned Accreditation and Quality Executive with over three decades of rich, diversified experience in the healthcare sector. She has spent over 20 years building and growing successful accreditation programs at large Health Care Companies Elevance Health (formerly Anthem) and Kaiser Foundation Health Plans consistently earning 100% scores on NCQA reviews. These accreditations include the full suite of NCQA product offerings such as Health Equity and Health Equity Plus, Health Plan, UM, Credentialing, Case Management, Special Needs Plans, MOC, and MBHO. Medicaid plans that Tammy has managed are among the first to achieve Health Equity Accreditation, and the first to achieve Health Equity Plus Accreditation, at a national level. She holds a Master of Public Health from UTHealth Houston. 

Dayna Jones, MBA, MS

Dayna Jones is Executive Director, Quality & Accreditation Governance at Aetna. She provides leadership and develops strategy to drive improvements to meet CMS, federal and state regulations, as well as accreditation requirements for all Aetna health plans. Prior to joining Aetna, Dayna was a principal consultant for Bell Business Solutions, where she worked with organizations preparing for NCQA Accreditation. Previous to that, she was Senior Director, Enterprise Quality & Accreditation at HCSC. Before HCSC, Dayna was Assistant Vice President of Accreditation at NCQA. Dayna has been an NCQA surveyor since 1999. She holds an MBA and an MSM with a concentration in Health Care Administration, both from the University of Maryland.

Continuing Education

This is a non-accredited activity.

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:

Tammy MacDonald, MPH: None
Dayna Jones, MBA, MS: None

Additional Planning Committee Members:
Kim Walters: None
Vince Pereira: None

This program was developed in part by NCQA staff.