New NCQA Medical Home Recognition Process Links to Meaningful Use

Earlier this week (1/31), NCQA released the PCMH 2011 recognition program. In full disclosure, I was a member of the NCQA Advisory Committee for this program.

From the press release:
“Federal ‘meaningful use’ language is embedded in PCMH 2011 evaluation standards, reinforcing incentives for practices to use health information technology to improve quality. The standards’ alignment with meaningful use creates a virtuous cycle: practices that meet PCMH 2011 requirements will be well prepared to qualify for meaningful use, and vice versa.” Appendix 2, included with the download (see below), provides a crosswalk between the PCMH 2011 and Stage 1 of Meaningful Use.

Also from NCQA is the description of the standards and must pass elements:

The PCMH 2011 program’s six standards align with the core components of primary care.

PCMH 1: Enhance Access and Continuity

PCMH 2: Identify and Manage Patient Populations

PCMH 3: Plan and Manage Care

PCMH 4: Provide Self-Care and Community Support

PCMH 5: Track and Coordinate Care

PCMH 6: Measure and Improve Performance

The Must-Pass Elements

Six must-pass elements are considered essential to the patient-centered medical home, and are required for practices at all recognition levels. Practices must achieve a score of 50% or higher on must-pass elements:

1.  PCMH 1, Element A: Access During Office Hours

2.  PCMH 2, Element D: Use Data for Population Management

3.  PCMH 3, Element C: Care Management

4.  PCMH 4, Element A: Support Self-Care Process

5.  PCMH 5, Element B: Track Referrals and Follow-Up

6.  PCMH 6, Element C: Implement Continuous Quality Improvement

The full paper documentation is available free from the NCQA website. (You will need to register, then receive an email, and then download.) The web-based survey tool will be available in March 2011 for a fee. Submission for recognition by NCQA is based on the number of sites and clinicians. The general outline of the fee schedule is in the document labeled, “Front Matter”(p 14), which is among the files provided with the download.

NCQA also includes with the download a document that provides additional background, including the following two graphs which highlight the growth of the program:

ScreenHunter_08 Feb. 01 17.11

ScreenHunter_09 Feb. 01 17.12

The NCQA announcement comes approximately one month after URAC announced their Patient-Centered Health Care Home in late December.  More about URAC in a subsequent blog.

This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.

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