Joint Commission Resources Project

Selected JCR Education Meets ABQAURP Certification Requirements

The Joint Commission (TJC) is an independent, not-for-profit organization that accredits and certifies nearly 21,000 health care organizations and programs in the United States and is recognized nationwide as a symbol of quality that reflects an organization’s commitment to improving health care quality and patient safety. Joint Commission Resources (JCR), a wholly owned subsidiary and knowledge-based organization of The Joint Commission, provides innovative solutions to health care organizations across all settings with the aim to improve patient safety and quality.

JCR courses may be used for Health Care Quality Management (HCQM) recertification of ABQAURP Diplomate physicians, nurses, and other health care professions in patient safety and health care quality. The selection will be based on educational gaps to enhance their professions, within the hospital or physician practice.

Based on the HCQM Exam key concepts, ABQAURP authorized the JCR pre-approval of selected educational materials for Diplomate recertification. Look for the ABQAURP preapproval statement listed below to ensure the course material qualifies for HCQM recertification.

ABQAURP | American Board of Quality Assurance and Utilization Review Physicians
The Joint Commission is authorized to award pre-approved ABQAURP qualified education credit for select programs that meet the Health Care Quality & Management (HCQM) exam eligibility requirements, or recertification requirements for ABQAURP Diplomates. Participants wishing to have JCR continuing education hours in select programs applied toward ABQAURP recertification credit should indicate their attendance when submitting application to ABQAURP.

JCR links to live & online courses:
Live Conferences and Seminars
http://www.jcrinc.com/find-event/
Webinars http://www.jcrinc.com/store/learning-events/webinars/
JCR Quality and Safety Network (JCRSN)              
http://www.jcrinc.com/store/learning-events/jcrqsn-1/
eCourses http://www.jcrinc.com/education/jcr-and-lippincott/
   

Key concepts covered in ABQAURP's HCQM Examination include:

Accreditation Organizations

  • American Board of Quality Assurance and Utilization Review Physicians (ABQAURP)
  • National Committee for Quality Assurance (NCQA)
  • Healthcare Effectiveness Data and Information Set (HEDIS®)
  • The Joint Commission
  • ISO (International Organization for Standardization)
  • National Quality Forum (NQF)

Transitions of Care (TOC)

  • Transitions of Care Models
  • Patient Protection & Affordable Care Act (PPACA)
  • American Recovery & Reinvestment Act (ARRA)
  • Seven Essential Elements
  • Readmission Avoidance

Credentialing and Privileging

  • Core Competencies
  • The Data Bank
  • Medical Staff Credentialing / Recredentialing
  • Institutional Bylaws
  • Economic Credentialing

Pay-for-Performance

  • Meaningful Use
  • Leapfrog Group
  • Provider Performance
  • Value-Based Purchasing

Insurance and Managed Care

  • Accountable Care Organizations
  • Health Maintenance Organizations (HMOs)
  • Medicare
  • Medicaid
  • Preferred Provider Organizations (PPOs)

Workers' Compensation (WC)

  • Compensability
  • Independent Medical Exams (IME)
  • Disability Protocols
  • Regulations

Physician Advisor Medical Specialty

  • Defining the Physician Advisor's Role
  • Two-Midnight Rule
  • Management of Observation Services
  • Medicare Audits, Denials, and Appeals
  • Transition to ICD-10

Quality Improvement, Management and Assurance

  • Theoretical Concepts
  • Quality Improvement Organizations (QIOs)
  • Peer Review
  • Continuous Quality Improvement (CQI)
  • Total Quality Management (TQM)
  • Physician Quality Reporting System (PQRS)

Clinical Resource Management

  • Utilization Review
  • Medicare Audits
  • Demand & Disease Management

Case Management

  • Case Management Components
  • Legal & Ethical Principles
  • Informed Consent

Risk Management / Patient Safety

  • Stark Laws
  • Anti-Kickback Statutes / Safe Harbor
  • Patient Self Determination Act (PSDA)
  • Informed Consent
  • Patient Safety Initiatives
  • Computerized Physician Order Entry (CPOE)

Regulatory Environment

  • Health Insurance Portability and Accountability Act (HIPAA)
  • Centers for Medicare & Medicaid Services (CMS)
  • Employee Retirement Income Security Act (ERISA)
  • Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • Affordable Care Act (ACA)
  • Health Care Quality Improvement Act (HCQIA)