Health Plan Accreditation 2025 Updates: Credentialing

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About this Live Training

Health Plan Accreditation 2025 Updates: Credentialing

This live course leads learners through a deep dive into the updates for the 2025 HPA standards for Credentialing (CR). Through this course, presenters will provide you with insight to interpret the requirements, navigate the standards, and avoid misconceptions. In addition to answering live questions, the presenters address scenarios and examples based on performance improvement opportunities from prior NCQA surveys.

Please note that this course presents information based on HPA 2025 standard requirements that are released in July 2024. The scope of this course applies directly to NCQA Accreditation Surveys conducted between July 1, 2025, and June 30, 2026.

What You Will Learn

At the conclusion of this course, learners will be able to:

• Understand the 2025 updates and changes to the standards and requirements. 
• Interpret the intent of HPA requirements.
• Describe relationships and themes across the standards.
• Recognize requirement implications and considerations for stakeholders.
• Define performance improvement opportunities.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

Who Should Attend

Clinicians, executives, managers, specialists, consultants, delegates and vendors who are employed or contracted by health plans with responsibilities pertaining to the scope of work listed below:

• Health care professional.
• Health decision makers
• Consultant.
• Health plan.
• Health Systems
• Population health organizations

Faculty

Marilyn O’Leary O’Shea, MBA
Consultant

Continuing Education

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. 

This activity was planned by and for the healthcare team, and learners will receive 3.0 Interprofessional Continuing Education (IPCE) credit for learning and change. 

This educational activity is approved for: 3.0 AMA PRA Category 1 Credit^TM, ANA CNE and ACPE.

The assigned universal program number:  JA0004597-0000-24-019-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 course grants 2.0 Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  

NABP Credit Reporting 

If you are a pharmacist completing a course offering CPE credits, please notify NCQA through ncqa.org within 14 calendar days that you have completed a CPE course. You must provide the title of the course, your NABP identification number and your DOB (month/date) within the notification to NCQA. We also recommend you update your education.ncqa.org profile with your NABP identification number.  

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:
Marilyn O’Leary O’Shea

Additional Planning Committee Members:
Felicia Khaalid: None 

This program was developed in part by NCQA staff.

Event Type

1. Live Online