MHR Newsletter
2023 #13
December 20, 2023
By: Nancy Ross Bell
From Susan
We heard you!
When we surveyed our clients in 2022, we heard some weren’t aware of many of our optional training programs, and if they were, they wanted pricing at an organizational rate rather than by individual.
We took action!
We changed to a flat rate for large group training and increased our communications by sending you 25 blogs and 13 newsletters. (If you are not on our mailing list, let us know!)
We offered you more!
We didn’t stop with blogs and newsletters! We offered you two client-only training webinars and developed a new consulting and training session on Staffing Assessment that is rolling out in 2024.
We met you face-to-face!
While at NCQA’s Quality Summit and a Rise Health Institute conference on Health Equity, we were thrilled to meet you and hear about your dedication to NCQA Accreditation.
And now,…looking ahead to 2024!
As 2023 comes to a close and 2024 is near, MHR is poised to continue bringing you high-quality consultation on NCQA accreditation where you need us the most. See How We Work. Schedule a Discovery Call.
Susan K. Moore, President & CEO
MHR CONSULTANTS
We want you to know…
Our recent blog on Are You Staffed Up for Your NCQA Survey was written with expert advice from MHR Consultant Kim Carpenter Petit. Her name was inadvertently omitted, for which we apologize.
GET TO KNOW MORE ABOUT
JEAN LOCKINGTON, MA, RN
MHR Consultant
Jean Lockington has the distinct honor of being one of MHR’s consultants, joining Susan in 2016 to help meet the needs of MHR’s growing client list. Jean had the unique background in leading NCQA Accreditation at a major health care management company, plus ten years as an NCQA surveyor, which makes MHR one of the top consulting firms today on NCQA Accreditation preparation. What is unique about MHR’s consultants is that they have all “walked in the same shoes” as their clients and have faced similar challenges.
While first working with Susan on an NCQA survey, Jean learned more about the coveted role of consultation, where clients entrust you with their organization’s path to NCQA Accreditation. Having a background in teaching at a hospital and as an adjunct professor in quality and health care, Jean knew she could combine her experience and love for teaching and impact other organizations.
Jean has consulted with many clients pursuing NCQA Accreditation, and what she has found most satisfying is experiencing organizations transform themselves by integrating quality measurement into their daily practices.
In 2024 Jean is concentrating on organizations needing their Models of Care (MOC) reviewed for compliance with CMS standards. As an NCQA Executive Reviewer for MOC, Jean is always on top of these requirements, and MHR is fortunate to have her on its team!
When Jean is not working on NCQA matters, she divides her time with family between her homes in New Jersey and North Carolina. She is passionate about her four grandchildren, who range in age from 7 to 13 years old and are highly active in many sports.
Read more about Jean and other MHR consultants on our website. Looking for more information on MOC review? See below under Quality Insights.
NEWS
5 Healthcare Industry Trends For 2024
2024 Outlook for Health Care Planning for the Future of Health: Top Trends for 2024
10 Things About Long-Term Services and Supports (LTSS)
The Broader Policy Implications of the Medicaid Unwinding Crisis
Survey on Racism, Discrimination and Health: Experiences and Impacts Across Racial and Ethnic Groups
Proposed Rule Changes for Mental Health Parity Requirements and Impacts on Local and Regional MCOs
The Hidden Costs of Provider Abrasion for Payers
States Ramp Up Scrutiny of Payers’ AI Use
8 Effective Strategies to Reducing Denied Claims
What States are Doing to Keep People Covered as Medicaid Continuous Enrollment Unwinds
QUALITY INSIGHTS
- Model of Care (MOC) submissions are due in February.
Are you on track with meeting the requirements for your MOC? Having a review by an expert before submitting could help your chances of obtaining a higher score and a longer approval period.
Special Needs Plans are required to submit their MOC to CMS for review by NCQA according to CMS’s guidelines with ultimate approval by CMS. NCQA assigns each organization a score and approval period, which you can find on NCQA’s site for Model of Care Scores.
For more information on MOC, view NCQA’s videos on SNP Approval Model of Care Training for CY 2025. Are you looking for more personal one-on-one assistance? Call MHR now before you run out of time for CY 2025.
Keep in mind that the best time to begin the annual review of a MOC is in September to allow ample time for review and revision as necessary. Mark your calendar now for September 2024 in preparation for CY 2026!
- Review NCQA’s proposed changes for 2025 standards.
Significant changes are proposed for the 2025 standards, and you have the opportunity to provide comments. Look here.
- Don’t stop now!
Remember that NCQA’s proposed changes are just that – proposed! Follow the current year's standards by which your organization will be surveyed and not the proposed ones. NCQA’s 2025 standards are effective for surveys on or after July 1, 2025.
- Have you read this from NCQA?
NCQA Comments on HHS Proposed Rules on Discrimination on the Basis of Disability
- Did you purchase your standards for all users?
NCQA’s Store has many of the standards for July 1, 2024 – June 30, 2025, while others are anticipated in December 2023. Make plans to purchase standards for your number of users. Not sure how many? Read NCQA’s Publication License Agreement.
- Keep updated with MHR’s Blogs and Newsletters!
MHR’s Blogs are written with YOU in mind – the people doing the work for an upcoming NCQA survey and maintaining quality once your survey scores are in! Be sure to distribute them to your quality teams as they provide unique insights from our Consultants.
UPCOMING INDUSTRY EVENTS
February 22, 2024
NCQA’s Live Webinar on Race, Ethnicity, SOGI, Income, and Language in Patient Reg
- Webinar
February 27-29, 2024
AHIP Executive Leadership Summit
- Phoenix, AZ
March 4-5, 2024
NCQA Health Equity Forum
- Los Angeles, CA
March 12-14, 2024
2024 Medicare, Medicaid, Duals, & Commercial Market Forum
AHIP
- Baltimore, MD
April 2-3, 2024
The Medicaid Managed Care Leadership Summit
- Virtual
April 19-22, 2024
2024 National Conference American Case Management Association
- Nashville, TN
May 29-30, 2024
CMS Health Equity Conference
- Bethesda, MD/Virtual
- Las Vegas, NV
October 31-November 2, 2024
NCQA Health Innovation Summit
- Nashville, TN
MHR was incorporated in 1991 and specializes in preparing organizations for all NCQA accreditation and certification products.
All MHR consultants were responsible for NCQA accreditation in their previous roles before joining MHR as an independent consultant. Most consultants are also NCQA surveyors and the majority are clinicians.
We welcome hearing from you!
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