ABQAURP News June 2024

Health Care News

    • ABQAURP recognizes Diplomate member Deepak Manmohan Goyal, MD, MBBS, MBA, CPE, CHCQM, CMRP, CMPC. Learn how he developed a streamlined presumptive-eligibility process for charity care at Monument Health to help patients who are unable to afford their care. Read more.
    • The World Health Organization (WHO) launched a Patient Safety Rights Charter at the Global Ministerial Summit on Patient Safety. It is the first Charter to outline patients’ rights in the context of safety, and will support stakeholders in formulating the legislation, policies and guidelines needed to ensure patient safety. Read the full article here. 
    • Continuing a 35-Year History, the Agency for Healthcare Research and Quality (AHRQ) Pursues Vital Pathways to Improve Patient Care. Learn the latest about their commitment to enhancing patient safety and health care quality. Read more.

Notice from ABQAURP’s Board of Directors: Changes to the Diplomate Recertification Cycle Dates

The Board of Directors of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) announces a change to the Diplomate Recertification Cycle, effective immediately. The new biennial recertification cycle will run e from October 1st through September 30th of year two. This change amends the previous recertification cycle that was January 1st to December 31st of the second year.

What does this mean for you? If you are due to recertify in 2024, you will need to meet the education requirement to recertify by September 30, 2024.
The Board of Directors have carefully considered this valuable update for ABQAURP’s Diplomates. The change will allow Diplomates to complete recertification earlier in the calendar year, avoiding the stress of recertifying over the holiday season. To support this transition, the grace period for recertification has been extended through December 31, 2024.

What is not changing for Health Care Quality and Management (HCQM) Recertification:

  • The recertification cycle is two (2) years.
  • Complete a minimum of 8 CME / CE credit hours of continuing education as relevant to the fields of Health Care Quality and Management per 2-year recertification cycle.
  • Remain current with all account balances.
Read the complete HCQM Recertification Policy here.

What is not changing for the Advanced Physician Advisor Recertification:

  • The recertification cycle is two (2) years.
  • Complete a minimum of 20 CME / CE credit hours of continuing education as relevant to the field of Physician Advisory per 2-year recertification cycle.
  • Remain current with all account balances.

Read the complete Advanced Physician Advisor Recertification Policy here .

Contact ABQAURP with questions at abqaurp@abqaurp.org or call (800) 998-6030.

Embracing Technology to Empower Health Care Quality Leaders
2024 Annual Conference Featured Session:

Charting the Course: Leadership Insights in Healthcare Systems

Pranav Mehta, MD, MBA, FACHE, CPE
Chief Medical Officer American & Atlantic Groups and Vice President of Clinical Operations – HCA Healthcare

Understanding the essential components of hospital system capacity and capability management are crucial for ensuring efficient and effective healthcare delivery. Capacity refers to the ability of a hospital to accommodate patient demand while maintaining quality standards, encompassing factors such as bed availability, staffing levels, and equipment resources. Capability, on the other hand, involves the hospital’s proficiency in providing a wide range of services and responding to diverse patient needs. Effective management of capacity and capability requires careful planning, resource allocation, and continuous monitoring to ensure that the hospital can adapt to fluctuating demand while maintaining high standards of care. By understanding these components, healthcare leaders can strategically optimize operations, enhance patient satisfaction, and improve overall healthcare outcomes within the hospital system.

The role of information technology (IT) and artificial intelligence (AI) in optimizing patient care delivery and operational efficiency is paramount in modern healthcare systems. IT systems, such as electronic health records (EHRs) and telemedicine platforms, streamline communication and facilitate the sharing of patient information among healthcare providers, ensuring coordinated and efficient care delivery. Additionally, AI technologies can analyze vast amounts of healthcare data to identify patterns, predict outcomes, and personalize treatment plans, ultimately improving clinical decision-making and patient outcomes. Moreover, AI-powered tools automate administrative tasks, optimize resource allocation, and enhance workflow efficiency, allowing healthcare organizations to allocate their resources more effectively and focus on delivering high-quality patient care. Embracing IT and AI innovations empowers healthcare providers to deliver more timely, accurate, and patient-centered care while driving operational excellence and cost-effectiveness in healthcare delivery.

Implementing strategies to ensure quality and safety within hospital systems is paramount for delivering optimal patient care. Firstly, embracing evidence-based practices enables healthcare providers to rely on the latest research and clinical guidelines, ensuring that treatments and procedures are grounded in the best available evidence. Continuous quality improvement initiatives further enhance patient safety by fostering a culture of ongoing assessment, feedback, and refinement of healthcare processes. Additionally, leveraging IT solutions plays a crucial role in mitigating risks and improving patient outcomes. IT systems such as EHRs facilitate the timely access to patient information, reducing errors and ensuring care coordination across multidisciplinary teams. Moreover, AI-powered analytics can identify potential safety concerns and predict adverse events, enabling proactive interventions to prevent harm. By integrating evidence-based practices, continuous improvement efforts, and IT solutions, hospital systems can enhance quality and safety standards, ultimately leading to better patient outcomes and improved healthcare delivery overall.

Register Here. 

There is Still Time to Register for ABQAURP’s 2024 Annual Conference!

ABQAURP’s 47th Annual Conference offers attendees the opportunity to learn about the latest trends in the health care quality and patient safety industry.
Our annual event has become the preeminent conference to network with your health care colleagues!

Attain Current and Topical Information!
Stay Ahead of the Curve! Bring back the knowledge and skills to adapt to sweeping changes in the health care landscape. Boost your expertise with our education! The result will be more proficient and expedited care, allowing for a better, safer health experience for both patients and providers.
Earn Valuable Continuing Education Credits!
Maintain your certification and ensure you are expanding your knowledge about important topics that are shaping our way of healing every day. ABQAURP’s conference offers specialized and current education about important factors in today’s health care field. Members of the interprofessional health care team earn CME/CE in content areas that are valuable to you.
Connect with the Field!
Interact with your peers and our industry-leading faculty at events planned to encourage networking like the reception and during meals. Gain perspective and learn valuable first-hand experiences as this specialized group of interdisciplinary team members impart their successes and failures, allowing you to take back an arsenal of information to implement at your workplace.
Refer a Colleague!
Do you know a colleague that would benefit from ABQAURP education or membership? Invite them to our conference to discover our top-notch education! You will recieve 50% off your registration fee when one non-member colleague attends conference. Your registration is free when two non-member colleagues attend conference!

Register Today! 

Disney’s BoardWalk Inn

Rooms in this block are available at a limited quantity and on a first-come, first-served basis and selling out quickly!

Reserve your hotel now for our special rate of $275 per night, plus applicable taxes, single/double occupancy. Rate includes complimentary Internet access, health club admission, phone calls, and local area transportation throughout the Walt Disney World® Resort, including theme parks and Disney Springs®.

To make your reservations, reserve online or call the Disney Group Reservations Phone Team at (407) 939-4686. Be sure to identify yourself as an ABQAURP Conference Attendee to receive the ABQAURP room rate and benefits.

Reserve your hotel room here.

Visit Our Conference Exhibitors!
View Exhibit and Sponsorship opportunities here. 

New Courses Available in ABQAURP’s Center for Continuing Education!
CME Available!

CMS-HCC Risk Adjustment Model Version 28: Be Proactive
Faculty: Dennis P.H. Mihale, MD, MBA, CHCQM-PSRM and Julio C. Perez, MD, AHCCA

What can you do to mitigate the impact of the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Codes (CMS-HCC) risk adjustment model Version 28? This course reveals a proactive approach to mitigating the potential negative impact of Version 28 through proper identification of diseases and conditions coupled with addressing, assessing, and properly treating those diseases.

A Quality Management Case for Participatory Healthcare 
Faculty: Daniel Halpren-Ruder, MD, PhD, CHCQM

Participatory health care (PHC) intrinsically expands Health Care Quality Management by encouraging the health care consumer (HCC) and the health care provider (HCP) to resolve the barriers that currently lead us to a variety of quality challenges. This course provides an overview of the attributes of the participatory patient and their provider together with a suggested pathway to a mutually participatory relationship.

Telehealth Standards in Practice 
Faculty: Erin Smith Aebel, Shareholder, Trenam Law

Although telehealth has been part of the health care industry for a long time, the unique circumstances and challenges of the pandemic made telehealth a high-priority and the focus of state and federal lawmakers, who rushed to expand access to remote health care for patients across the country. Although telehealth is now a ubiquitous topic in the health care industry, to understand it and how state and federal laws apply, a fundamental question must be answered – What is telehealth?
This course reviews the legal aspects of telehealth practice standards, licensing, credentialing, reimbursements through government and private insurers, and concerns with fraud and abuse in telehealth practices.

Introduction to Organizational Excellence
Faculty: Anthony Pepe, BA, MHA, CSSBB, Shingo Alumni

This course focuses on achieving organizational excellence through key principles and practices. Participants will delve into psychological safety, explore the Shingo Model, learn about Rules in Use for improving work processes, and harness the power of self-reflection. This course will present the core concepts of organizational excellence, drawing from the insights of the Paul O’Neill Trilogy, the importance of psychological safety, the principles outlined in the Shingo Model, and the implementation of Rules in Use for creating a learning organization. Paul O’Neill’s philosophy emphasizes habitual excellence, rooted in safety, quality, and respect for individuals, alongside a commitment to continuous improvement.

A Message from Our Corporate Member: Value Capture


Value Capture, trusted advisors that guide health systems determined to produce perfect health with zero harm, wait, or waste—for patients, teams, and communities.
Our proven methodologies have helped health systems across the country achieve remarkable results, including:

Reducing providers after-hours work from 90 to 60 minutes at a primary care clinic

  • Improving Operating Room on-time starts by reducing supply problems
  • Reducing readmission rates by 12% in a multi-hospital system
  • Reducing average length of stay for surgical patients by 46%
  • Achieving zero patient wait times and a 43% reduction in total clinic visit durations

Learn more about our clients’ successes.

Earn the credential of Certified Advanced Physician Advisor – CPHYADV!

Register for the Advanced Physician Advisor Certification Exam! Validate Your Expertise!

After working tirelessly with our esteemed panel of seasoned Physician Advisor subject matter experts and psychometricians, we have completed the development of this new ABQAURP board certification, and we are now taking applications!

The exam was developed by a team of expert Physician Advisors with the goal to elevate the skills of all Physician Advisors! The certification exam is designed to validate the knowledge of the Advanced Physician Advisor. Testing not only the basics, but practical application of concepts and skills used in everyday practice. The Advanced Physician Advisor board certification enhances the credibility of the physician advisor practicing today in health systems, hospitals, and ancillary facilities.

Relying on our 47 years of certification expertise, this psychometrically sound board certification was developed under the guidance of a diverse panel of seasoned subject matter experts and Certification Management Services (CMS) to ensure a valid, reliable certification exam. Developed by Physician Advisors for Physician Advisors, with well-defined topics identified through a robust competency analysis, the certification exam blueprint and exam items were written by a team of credible experts serving in a variety of Physician Advisor roles throughout the country.

Candidates who successfully complete the advanced board certification exam will earn the credential of Certified Advanced Physician Advisor (CPHYADV). Earning this credential leverages Physician Advisors for professional opportunities and allows you to stand out amongst your peers.

The Advanced Physician Advisor Certification Exam window is open July 1 through September 30, 2024. Register now and save 15% through July 15 with promo code APACER24

ABQAURP offers candidates in-person testing at Meazure Learning Test Centers or remote testing via the MonitorEDU remote proctoring system.

Read eligibility requirements and get started now!  

HCQM Certification Exam 2024 – Apply Today!

Prepare for Excellence with HCQM Certification!
For 47 years, health care professionals certified in Health Care Quality and Management (HCQM) have shown their commitment and specialized focus in quality care and patient safety that distinguishes them from their colleagues.

HCQM Certification demonstrates that ABQAURP Diplomates have the practical knowledge to reduce medical errors, ensure patient safety, eliminate waste and unnecessary services, while avoiding potentially harmful delays in care. Certification verifies to internal and external entities that you, your group practice, or hospital is accountable. The result is a safer, more efficient and cost-effective system that better satisfies the needs of patients, providers, purchasers, and payers.

Professionals who have achieved certification in HCQM are committed to patient safety, health care quality, and effective care. Those certified in HCQM demonstrate their superior ability to critically evaluate industry literature, identify evidence-based best practices, and make recommendations that balance appropriateness of health care services with cost and quality.

The 2024 exam window is open from April 1st through September 30th. Test in-person at a Meazure Learning Test Center or test remotely via the MonitorEDU remote proctoring system. MonitorEDU allows you to test safely, reliably, securely, at any time, and from any location, through a proven remote online assessment platform.

*While MonitorEDU allows an exam candidate to test anywhere, it is recommended that your work network not be utilized due to firewall and other security concerns.

Register here.

Sub-Specialty Certifications are available in the following categories:

  • Case Management – CHCQM-CM
  • Managed Care – CHCQM-MC
  • Patient Safety/Risk Management – CHCQM-PSRM
  • Physician Advisor (US-licensed physicians only) – CHCQM-PHYADV™
  • Transitions of Care – CHCQM-TOC
  • Workers’ Compensation – CHCQM-WC

Prepare Now with the Core Body of Knowledge Online Course!

To prepare for the certification exam, we have developed the Core Body of Knowledge (CBK) online course focusing on the key concepts and elements of HCQM.

In the CBK Online Course, you will learn the basics of health care quality, risk management, accreditation, and patient safety, including:

  • Identify tools and processes used to determine quality of care issues in a variety of health care environments
  • Discuss the use of peer review in assuring quality of care in a variety of settings
  • Recognize patient safety cultures outside of health care
  • Explain various ways utilization is managed and costs are controlled
  • Explore basic concepts and frameworks of case management
  • Identify essentials of safe and effective transitions of care
  • Discuss the differences between accrediting organizations and regulatory agencies
  • Discuss critical regulatory issues (Stark law, Anti-kickback statute, etc.)
  • Specify how privileges are granted, maintained, and how they may be removed
  • Examine the impact of managed care on quality and utilization
  • Recognize Workers’ Compensation terminology and common definitions
  • Describe the roles and areas of potential influence for the experienced physician advisor
  • Describe how the definition of observation services differs from inpatient status

This course is intended for Physicians of all specialties, Nurses, and Other Health Care Professionals with appropriate CME / CE credit offered for each profession.

Click here to order the Core Body of Knowledge.

Core Body of Knowledge Online Course Credits:
ABQAURP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
ABQAURP designates this enduring material for a maximum of 26 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 26 contact hours through the Florida Board of Nursing, Provider #50-94.

ABQAURP Professional Membership
Join ABQAURP Today and Be Recognized for Your Commitment to Health Quality Health Care and Patient Safety!

Learn more about Professional Membership here. 

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