Self Paced

Explaining Health Plan Accreditation (HPA) 2022 Series ...

These OnDemand courses presents information based on the requirements from the HPA 2022 Standards. Therefore, the content of these OnDemand courses applies directly to NCQA Accreditation Surveys conducted between July 1, 2022 and June 30, 2023.

About this On Demand Training

Explaining Health Plan Accreditation (HPA) 2022 Series (OnDemand)

Course Description

Faculty 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.

These Ondemand courses presents information based on the requirements from the HPA 2022 Standards. Therefore, the content of these OnDemand 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.

Note: Each attendee must register as a unique participant, as required by the NCQA Terms of Use

Group Training?
For inquiries regarding group training rates, please complete our online form.

Key Topics

Network Management (NET) – OnDemand (Approximate Run Time: 2.5 hrs)
•    Evaluating adequacy of networks.
•    Conducting qualitative and quantitative analyses.
•    Demonstrating timeliness for network decisions.
•    Assessing out-of-network utilization.
•    Measuring effectiveness of interventions.

Utilization Management (UM) – OnDemand (Approximate Run Time: 2.5 hrs)
•    Controlling UM systems.
•    Handling member appeals.
•    Determining coverage and medical necessity.
•    Administering denial notices.

Member Experience (ME) – OnDemand (Approximate Run Time: 2.5 hrs)
•    Communicating benefits with clarity and accuracy.
•    Distributing subscriber information.
•    Measuring quality and accuracy of communications.
•    Supporting members with benefit related decisions.

Credentialing (CR) – OnDemand (Approximate Run Time: 2.5 hrs)
•    Controlling credentialing systems. 
•    Managing credentialing committee.
•    Administering credentialing verification.
•    Monitoring interventions continuously. 
•    Assessing organizational providers.

Population Health Management (PHM) – OnDemand (Approximate Run Time: 2.5 hrs)
•    Constructing a comprehensive PHM strategy. 
•    Assessing patient populations.  
•    Managing complex cases. 
•    Managing value-based payment arrangements. 

Quality Management and Improvement (QI) – OnDemand (Approximate Run Time: 2.5 hrs)
•    Planning, evaluating, and controlling QI interventions. 
•    Incorporating contracted practitioners and providers into QI.
•    Coordinating care across the network. 
•    Measuring effectiveness of QI interventions.

Benefits and Resources
•    Presenting Slides. 
•    Recording of Live Session.
•    Live Q&A. 
•    Scenarios for Applied Learning.
•    Perspective from Former NCQA Policy Staff.
•    ACCME Credits for Clinicians. 

What You Will Learn

  • Explain 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

•    Clinicians, Directors, Managers, Specialists, and Coordinators
•    Consultants, Contractors, Delegates, and Vendors
•    Health Plans and Managed Care Organizations
•    Professionals in Provider Relations 
•    Professionals in Population Health or Public Health
•    Professionals in Compliance, Public Policy, or Risk Management
•    Professionals in Quality Assurance/Improvement or Performance Measurement

Continuing Education

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) to provide Interprofessional Continuing Education for the healthcare team. 

Explaining HPA 2022: Credentialing (CR)

This activity was planned by and for the healthcare team, and learners will receive 2.5 Interprofessional Continuing Education (IPCE) credit for learning and change.

This educational activity is approved for: 2.5 AMA PRA Category 1 CreditTM and ACPE.

This educational activity is approved for 2.5 nursing contact hours.*

The 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.

This live course grants 2.0 Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  

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

Explaining HPA 2022: Network Management (NET)

This activity was planned by and for the healthcare team, and learners will receive 2.5 Interprofessional Continuing Education (IPCE) credit for learning and change.

This educational activity is approved for: 2.5 AMA PRA Category 1 CreditTM and ACPE.

This educational activity is approved for 2.5 nursing contact hours.*

The 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.

This live webinar grants 2.0 other Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  

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

Explaining HPA 2022: Utilization Management (UM)

This activity was planned by and for the healthcare team, and learners will receive 2.5 Interprofessional Continuing Education (IPCE) credit for learning and change. 

This educational activity is approved for: 2.5 AMA PRA Category 1 CreditTM and ACPE.

The 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.

This live webinar grants 2.0 other Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  

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

Explaining HPA 2022: Member Experience (ME)

This activity was planned by and for the healthcare team, and learners will receive 2.5 Interprofessional Continuing Education (IPCE) credit for learning and change. 

This educational activity is approved for: 2.5 AMA PRA Category 1 CreditTM and ACPE.

The 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.

This live webinar grants 2.0 other Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  

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

Explaining HPA 2022: Population Health Management (PHM)

This activity was planned by and for the healthcare team, and learners will receive 2.5 Interprofessional Continuing Education (IPCE) credit for learning and change. 

This educational activity is approved for: 2.5 AMA PRA Category 1 CreditTM and ACPE.

The 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.

This live webinar grants 2.0 other Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  

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

Explaining HPA 2022: Quality Management & Improvement (QI)

This activity was planned by and for the healthcare team, and learners will receive 2.5 Interprofessional Continuing Education (IPCE) credit for learning and change. 

This educational activity is approved for: 2.5 AMA PRA Category 1 CreditTM and ACPE.

The 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.

This live webinar grants 2.0 other Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  

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

ATTENTION: Effective February 1, 2022, this on-demand (enduring material) activity no longer offers credits for the American Academy of Physician Assistants (AAPA), the American Psychological Association (APA), or the Association of Social Work Boards (ASWB). Only applicable professionals who fully completed this on-demand activity prior to February 1, 2022, are eligible for AAPA, APA, or ASWB credits. No other CEUs are impacted by this change.

Event Type
  1. Self Paced
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