About this Learning Activity

Health Plan Accreditation 201: Implementation - Population Health Management (PHM) Standards for Surveys through June 2028

This 201-level learning activity focuses on the Population Health Management (PHM) standards for Health Plan Accreditation. Through these interactive learning modules, participants receive guidance to interpret the requirements, navigate the standards, and avoid misconceptions. Participants explore how to use member data to identify population needs, devise services to address those needs, and measure the effectiveness of those interventions. Participants are also provided scenarios and examples drawn from performance improvement opportunities identified through prior surveys.

What You Will Learn

Key Topics

·       Population Health Strategy

·       Population Identification

·       Alternative Payment Models

·       Measuring Effectiveness

Learning Objectives

Throughout this course, learners will:

·   Explore examples for the most current version of Population Health Management standards.

·   Interpret the intent of Health Plan Accreditation requirements.

·   Recognize requirement implications and considerations for stakeholders.

·   Define performance improvement opportunities.

Learning Outcomes

After completing this course, learners will:

·   Develop and maintain evidence-based program policies and procedures.

·   Prioritize performance improvement initiatives.

·   Implement reliable and valid practices for population health management.   

Product Alignment

This learning activity supplements the standards and guidelines for Health Plan Accreditation. The scope applies directly to NCQA Accreditation Surveys conducted through June 30, 2028. This course is included for the Health Plan Accreditation Readiness Package for up to two (2) registrants per health plan. Readiness Package customers that need more than two (2) registrants must purchase additional registrations through this webpage.

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:

•       Case Management
•       Quality Improvement
•      Clinical Social Worker
•      Accreditation or Compliance 
  
  

Continuing Education

This course grants 2.0 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:

Additional Planning Committee Members:

Meghan Monahan: None

Vince Pereira: None

Kristen Swift: None

This program was developed in part by NCQA staff.

This program received no commercial support.