About this Learning Activity

Health Plan Accreditation 101: Foundations - Through June 2028

Built on more than 25 years of experience, NCQA Health Plan Accreditation provides a rigorous and all-inclusive outline for quality improvement and measurement. This self-paced course introduces participants to NCQA and the framework designed to improve the quality of care and services through NCQA’s Accreditation process. This learning activity is recommended for professionals new to NCQA programs and professionals monitoring updates pertaining to the NCQA Accreditation process.

What You Will Learn

Topics

• Categories of HPA Standards
• Anatomy of a Standard
• Evaluation Options
• Scoring and Accreditation Statuses

Learning Objectives

By participating within this learning activity, learners will:

• Define key terms used for Health Plan Accreditation.
• Explain Accreditation components and evaluation options.
• Discuss scoring thresholds and how they result in a status.
• Describe the Categories of Health Plan Accreditation.

Publication Alignment

This learning activity covers requirements from multiple versions of the Health Plan Accreditation program. Content updates, if any, are released two months after the publication's release. Learners are advised to refer to their Interactive Survey Tool (IRT) for guidance regarding their specific survey type and version. Learners are also advertised to review the "Notable Changes" table within the Front Matter of the e-Publication.

Who Should Attend

• Administrators and Clinicians
• Consultants, Contractors, and Vendors
• Directors, Managers, Specialists, and Coordinators
• Professionals at Health Plans or Managed Care Organizations
• Professionals of Credentialing or Provider Relations
• Professionals of Case, Utilization, or Care Management
• Professionals of Compliance, Regulation, or Public Policy
• Professionals of Population or Public Health
• Professionals of Performance, Quality, or Risk Management

Continuing Education

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

This is a non AMA PRA Category 1 CreditTM, 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:

Planning Committee
Vince Pereira: None
Julie Pung: None

Related Resources

• NCQA Survey Readiness Packages
• NCQA Publications
• NCQA FAQs

This program was developed by NCQA staff.

This program received no commercial support.