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SUMMARY:Explaining Health Plan Accreditation (HPA) 2022 Series
DESCRIPTION:About this Webinar Training\n\nCourse DescriptionFaculty 
 will equip participants with guidance for interpreting the 
 requirements\, navigating the standards\, and avoiding 
 misconceptions. Faculty will also facilitate short 
 activities to simulate how to address requirements. This 
 course is appropriate for any professional with either a 
 direct or indirect stake in NCQA Accreditation.\n\nThis 
 course presents information based on the requirements from 
 the HPA 2022 Standards. Therefore\, the content of this 
 course applies directly to NCQA Accreditation Surveys 
 conducted between July 1\, 2022 and June 30\, 2023.  For 
 courses pertaining to Delegation requirements\, please use 
 “Delegation” to search NCQA courses at 
 ncqa.org/education.\n\nNote: Each attendee must register as 
 a unique participant\, as required by the NCQA Terms of 
 Use. \nGroup Training?\nFor inquiries regarding group 
 training rates\, please complete our online form.\nKey 
 TopicsNetwork Management (NET) \nLive Webinar: October 7\, 
 2021\, 1:00 pm - 4:00 pm ET\n•    Evaluating adequacy of 
 networks.\n•    Conducting qualitative and quantitative 
 analyses.\n•    Demonstrating timeliness for network 
 decisions.\n•    Assessing out-of-network 
 utilization.\n•    Measuring effectiveness of 
 interventions.\nUtilization Management (UM)\nLive Webinar: 
 October 14 2021\, 1:00 pm - 4:00 pm ET\n•   
  Controlling UM systems.\n•    Handling member 
 appeals.\n•    Determining coverage and medical 
 necessity.\n•    Administering denial notices.\nMember 
 Experience (ME)\nLive Webinar: October 21\, 2021\, 1:00 pm - 
 4:00 pm ET\n•    Communicating benefits with clarity 
 and accuracy.\n•    Distributing subscriber 
 information.\n•    Measuring quality and accuracy of 
 communications.\n•    Supporting members with benefit 
 related decisions.\nCredentialing (CR) \nLive Webinar: 
 October 25\, 2021\, 1:00 pm - 4:00 pm ET\n•   
  Controlling credentialing systems. \n•    Managing 
 credentialing committee.\n•    Administering 
 credentialing verification.\n•    Monitoring 
 interventions continuously. \n•    Assessing 
 organizational providers.\nPopulation Health Management 
 (PHM) \nLive Webinar: October 27\, 2021\, 1:00 pm - 4:00 pm 
 ET\n•    Constructing a comprehensive PHM 
 strategy. \n•    Assessing patient populations. 
  \n•    Managing complex cases. \n•    Managing 
 value-based payment arrangements. \nQuality Management and 
 Improvement (QI)\nLive Webinar: November 4\, 2021\, 1:00 pm - 
 4:00 pm ET\n•    Planning\, evaluating\, and controlling 
 QI interventions. \n•    Incorporating contracted 
 practitioners and providers into QI.\n•    Coordinating 
 care across the network. \n•    Measuring 
 effectiveness of QI interventions.\nBenefits and 
 Resources\n•    Presenting Slides. \n•   
  Recording of Live Session.\n•    Live Q&A. \n•   
  Scenarios for Applied Learning.\n•    Perspective 
 from Former NCQA Policy Staff.\n•    ACCME Credits for 
 Clinicians. \nWhat You Will Learn\n\nExplain the intent of 
 the HPA Standards.Define performance issues and target 
 results within the scope of requirements.Describe 
 relationships and themes across the Elements for CR\, NET\, 
 UM\, ME\, PHM and QI.Discuss requirement implications and 
 considerations for stakeholder group.Critique examples and 
 scenarios to enhance application.Who Should 
 Attend\n\n•    Clinicians\, Directors\, Managers\, 
 Specialists\, and Coordinators\n•    Consultants\, 
 Contractors\, Delegates\, and Vendors\n•    Health Plans 
 and Managed Care Organizations\n•    Professionals in 
 Provider Relations \n•    Professionals in Population 
 Health or Public Health\n•    Professionals in 
 Compliance\, Public Policy\, or Risk Management\n•   
  Professionals in Quality Assurance/Improvement or 
 Performance Measurement\nFaculty\n\nClint Koenig\, MD\, MSPH\, 
 MAClint Koenig\, MD\, MA\, MSPH is the senior Medical Director 
 at Ohio Healthy\, 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.\nHe 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.\nDr. Koenig received his MD from Albany 
 Medical College in Albany\, NY. 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 Masters degrees in Public Health and 
 Journalism.\nShelly Smith\, RN\, MN\, CPHQShelly Smith is an 
 NCQA surveyor and recently retired owner and Managing 
 Consultant of Health Value Solutions\, LLC\, an independent 
 healthcare consulting firm based in Liberty Lake\, 
 Washington. She has extensive experience in the development 
 and implementation of health plan quality programs\, disease 
 management program development\, worksite wellness program 
 implementation and development of provider health care 
 quality measurement and pay for performance programs.  
 Through collaborative communication\, Shelly is a proven 
 leader in the successful preparation for health plan NCQA 
 accreditation both as a health plan leader and external 
 consultant and has provided successful consultation and 
 leadership in vendor\, employer group and provider 
 environments.\nShelly brings over 30 years’ experience in 
 the health care industry having held staff and leadership 
 positions in both the hospital and health plan setting. She 
 started her career as a registered nurse and spent 4 years 
 working with cardiovascular medical\, surgical and transplant 
 patients.  After completing her Master’s degree\, Shelly 
 transitioned to administrative roles where she served for 
 over 15 years as both the Quality Manager and later Director 
 of Quality with Medical Service Corporation and Premera Blue 
 Cross. In these roles she led 5 successful NCQA 
 accreditation efforts including commercial\, Medicaid and 
 Medicare membership\, maximized HEDIS results\, developed 
 physician pay-for-performance programs and implemented 
 successful disease management and employer-based wellness 
 programs. She formed Health Value Solutions in 2008 and has 
 worked with numerous health plans and vendors throughout the 
 United States to achieve successful NCQA 
 accreditation/certification since that time.  Shelly has 
 been a surveyor for the National Committee for Quality 
 Assurance (NCQA) since 1996. She has been faculty for Blue 
 Cross Blue Shield Association NCQA training earlier in her 
 career and served as faculty for NCQA Surveyor Update 
 training\, Intro to Accreditation and Advanced Accreditation 
 seminars in recent years.\nMs. Smith holds a Masters’ 
 Degree in Cardiovascular Physiological Nursing\, a 
 Bachelors’ degree in Nursing\, and a National Certification 
 in Healthcare Quality. \nJoseph Stankaitis\, MD\, MPH Joseph 
 A. Stankaitis\, MD\, MPH since 1997 has been the Chief Medical 
 Officer of the Monroe Plan for Medical Care\, an Individual 
 Practice Association (founded in 1970) and healthcare 
 management organization in Rochester\, New York and the Chief 
 Medical Officer of its safety-net health plan\, YourCare 
 Health Plan in Upstate and Western New York. He oversees all 
 clinically-related activities for these organizations\, 
 including its Health and Recovery Plan (HARP) for the 
 Seriously Mentally Ill. He is also the Principle 
 Investigator for Monroe Plan’s SAMHSA Grant\, “Addressing 
 Buffalo’s Opioid Epidemic with Medication Assisted 
 Treatment.”\nHe is a Fellow of the American College of 
 Physicians\, Fellow of the American Association for Physician 
 Leadership and Clinical Associate Professor of Family 
 Medicine at the University of Rochester School of Medicine 
 and Dentistry. He is an active reviewer and past Chair of 
 the Review Oversight Committee and current Chair of the 
 Reconsideration Committee for the National Committee for 
 Quality Assurance (NCQA). He is a member of the New York 
 State Department of Health Medicaid Evidence-Based Benefits 
 Review Advisory Committee. He is the President of the 
 American Diabetes Association (ADA) Rochester Volunteer 
 Leadership Board and has served as a member of the ADA’s 
 National Professional Practice Committee (develops national 
 practice guidelines for diabetes care).\nDr. Stankaitis 
 received a bachelor’s degree in biology from Boston 
 College\, his MD from the University of Connecticut and 
 completed his residency and chief residency in the Primary 
 Care Program in Internal Medicine at the University of 
 Rochester. As a Kellogg Foundation Fellow at Harvard 
 University\, he received a Master’s degree in Health Policy 
 and Management.\nFrank H. Stelling\, M.Ed\, MPHMr. Stelling is 
 a Senior Consultant with The Mihalik Group. Prior to joining 
 the Mihalik Group\, he was Assistant Director\, Accreditation 
 Policy at NCQA for 14 years. Mr. Stelling oversaw the Policy 
 Clarification Support System (PCS)\, a web-based tool for 
 customers to ask questions of Policy Accreditation staff 
 concerning all NCQA Accreditation and Certification 
 programs. He also directed all education efforts out of the 
 Policy Accreditation unit. In addition\, Mr. Stelling was the 
 lead on all federal and state deeming activities\, including 
 the Medicare Deeming program.\nMr. Stelling is also an NCQA 
 surveyor and has been part of survey teams for the 
 accreditation of Health Plans\, Managed Behavioral Health 
 Organizations. Disease Management Organizations and other 
 organizations for over 17 years. Mr. Stelling has over 40 
 years of experience in health care with focus on Preventive 
 Services\, Disease Management and Quality 
 Improvement.\nBefore joining NCQA\, he held management 
 positions with state and county health departments\, 
 hospitals\, voluntary health organizations and a managed care 
 organization. He holds a Master of Education from the 
 University of South Carolina and a Master of Public Health 
 from the University of California\, Berkeley.\nVeronica 
 Locke\, MHSAVeronica Locke is a consultant for The Mihalik 
 Group\, providing healthcare-related consulting services.  
 Her areas of expertise include quality assessment and 
 improvement\; credentialing\; delegation\; disease management 
 accreditation/certification\; population health management\; 
 multicultural health care.\nVeronica is the former Senior 
 Manager of Accreditation Policy for the National Committee 
 for Quality Assurance. She was actively involved in the 
 development and maintenance of the standards and guidelines 
 of NCQA's Accreditation and Certification programs\, 
 specifically Health Plan\, Disease Management and 
 Multicultural Health Care Distinction programs. As a member 
 of the Policy team\, one of her major responsibilities was to 
 serve as a content champion when providing policy 
 clarifications and trainings internally and externally.\nShe 
 received her Bachelor of Science Degree in Public Health 
 from the University of Maryland\, College Park and her Master 
 of Health Systems Administration Degree from Georgetown 
 University in Washington\, DC.\n \n Continuing 
 Education\n\n\n 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)\, the American Academy of 
 Physician Assistants (AAPA)\, the American Psychological 
 Association (APA)\, and the Association of Social Work Boards 
 (ASWB) to provide Interprofessional Continuing 
 Education for the healthcare team. \nExplaining HPA 2022: 
 Credentialing (CR)\nThis activity was planned by and for the 
 healthcare team\, and learners will receive 2.5 
 Interprofessional Continuing Education (IPCE) credit for 
 learning and change.\nThis educational activity is approved 
 for: 2.5 AMA PRA Category 1 CreditTM\, APA\, AAPA\, ACPE and 
 ASWB ACE.\nThis educational activity is approved for 2.5 
 nursing contact hours.*\nThe assigned universal program 
 number: . 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.\nThis live course grants 2.0 Continuing Education 
 Unit (CEU) points for PCMH Certified Content 
 Experts.  \n* Please note – You must attend the entire 
 program to be eligible for total number of contact 
 hours.\n\nExplaining HPA 2022: Network Management 
 (NET)\nThis activity was planned by and for the healthcare 
 team\, and learners will receive 2.5 Interprofessional 
 Continuing Education (IPCE) credit for learning and 
 change.\nThis educational activity is approved for: 2.5 AMA 
 PRA Category 1 CreditTM\, APA\, AAPA\, ACPE and ASWB 
 ACE.\nThis educational activity is approved for 2.5 nursing 
 contact hours.*\nThe assigned universal program number: 
 JA0004597-0000-21-012-L04-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.\nThis live webinar grants 2.0 other Continuing 
 Education Unit (CEU) points for PCMH Certified Content 
 Experts.  \n* Please note – You must attend the entire 
 program to be eligible for total number of contact 
 hours.\n\nExplaining HPA 2022: Utilization Management 
 (UM)\nThis activity was planned by and for the healthcare 
 team\, and learners will receive 2.5 Interprofessional 
 Continuing Education (IPCE) credit for learning and 
 change. \nThis educational activity is approved for: 2.5 
 AMA PRA Category 1 CreditTM\, ANA CNE\, APA\, ACPE and ASWB 
 ACE.\nThe assigned universal program number: 
 JA0004597-0000-21-010-L04-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.\nThis live webinar grants 2.0 other Continuing 
 Education Unit (CEU) points for PCMH Certified Content 
 Experts.  \n* Please note – You must attend the entire 
 program to be eligible for total number of contact 
 hours. \n\nExplaining HPA 2022: Member Experience 
 (ME)\nThis activity was planned by and for the healthcare 
 team\, and learners will receive 2.5 Interprofessional 
 Continuing Education (IPCE) credit for learning and 
 change. \nThis educational activity is approved for: 2.5 
 AMA PRA Category 1 CreditTM\, ANA CNE\, APA\, ACPE and ASWB 
 ACE.\nThe assigned universal program number: 
 JA0004597-0000-21-013-L04-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.\nThis live webinar grants 2.0 other Continuing 
 Education Unit (CEU) points for PCMH Certified Content 
 Experts.  \n* Please note – You must attend the entire 
 program to be eligible for total number of contact 
 hours. \n\nExplaining HPA 2022: Population Health 
 Management (PHM)\nThis activity was planned by and for the 
 healthcare team\, and learners will receive 2.5 
 Interprofessional Continuing Education (IPCE) credit for 
 learning and change. \nThis educational activity is 
 approved for: 2.5 AMA PRA Category 1 CreditTM\, ANA CNE\, APA\, 
 ACPE and ASWB ACE.\nThe assigned universal program number: 
 JA0004597-0000-21-011-L04-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.\nThis live webinar grants 2.0 other Continuing 
 Education Unit (CEU) points for PCMH Certified Content 
 Experts.  \n* Please note – You must attend the entire 
 program to be eligible for total number of contact 
 hours. \n\nExplaining HPA 2022: Quality Management & 
 Improvement (QI)\nThis activity was planned by and for the 
 healthcare team\, and learners will receive 2.5 
 Interprofessional Continuing Education (IPCE) credit for 
 learning and change. \nThis educational activity is 
 approved for: 2.5 AMA PRA Category 1 CreditTM\, ANA CNE\, APA\, 
 ACPE and ASWB ACE.\nThe assigned universal program number: 
 JA0004597-0000-21-009-L04-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.\nThis live webinar grants 2.0 other Continuing 
 Education Unit (CEU) points for PCMH Certified Content 
 Experts.  \n* Please note – You must attend the entire 
 program to be eligible for total number of contact 
 hours. \n
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