New NCQA Program Extends Medical Home Concepts Beyond Primary Care
WASHINGTON, D.C.—Today the National Committee for Quality Assurance (NCQA) extended concepts of the patient-centered medical home by launching a new evaluation program for specialists outside of primary care: NCQA Patient-Centered Specialty Practice (PSCP) Recognition.
The new program is modeled on NCQA’s Patient-Centered Medical Home Recognition program, the most widely adopted medical home model in the country. Under PCSP, specialty practices committed to improving access, communication and care coordination can earn accolades as the “neighbors” that surround and inform the medical home and colleagues in primary care.
“NCQA’s Patient-Centered Specialty Practice Recognition is an important step forward. I sincerely hope the specialty community embraces it, just as the primary care world has embraced the patient-centered medical home,” said Ed Wagner, MD, MPH, creator of the Chronic Care Model.
The PCSP program recognizes specialty practices that:
- Establish agreements with primary care clinicians to exchange key information and establish coordinated care planning and management.
- Provide timely access to care and clinical advice based on patient need.
- Use a systematic approach to identify and track patients and coordinate care.
- Include the patient and family or caregiver (if appropriate in planning and managing care).
- Work with a delivery/reimbursement model that focuses on outcomes and reduced duplication of services.
- Align with newly proposed physician delivery and payment models (e.g., accountable care organizations, episodes of care, bundled payments).
The PCSP program is aligned with the Centers for Medicare & Medicaid Services (CMS) Electronic Health Record Incentive Program’s Meaningful Use criteria in recognition of the importance of health information technology as a tool for coordinating information and clinical care. NCQA will use Stage 1 criteria to evaluate practices until January 1, 2015.
NCQA offers three levels of PCSP recognition. Level 1 represents a practice that meets the minimum score of 25 points (out of 100) and meets the mandatory elements. Practices earning additional points can qualify for higher levels of recognition, allowing growth within the PCSP program over time.
The standards for the new program are available for free here. A March 18, 2013, Webinar in which NCQA leaders and three physician-advisors who helped design the PCSP program discussed it and answered common questions is here.
Sixty-four organizations have enrolled to be early adopters of the PCSP program. They have committed to finishing key parts of the recognition process by the end of 2013, in exchange for pricing discounts and publicity support. The early adopters are:
- Affinity Health Group (LA)
- Allergy and Asthma Medical Group of the Bay Area (CA)
- AMEN Clinics - Reston Location (VA)
- Andrew W. Green, MD & Rita R. Sloan, MD - Adult & Pediatric Allergists (NY)
- Bassett Healthcare (NY)
- Cardiology Consultants of Philadelphia (PA)
- Carolina Center for Occupational Health (SC)
- Charleston Women's Wellness Center (SC)
- ColumbiaDoctors, Department of Urology (NY)
- ColumbiaDoctors, Division of GI and Endocrine Surgery (NY)
- ColumbiaDoctors, Division of Orthopedics (NY)
- Commonwealth Hematology-Oncology (MA)
- Consultants in Medical Oncology and Hematology (PA)
- CoxHealth, Regional Services, Adult Medicine and Endocrinology Specialists (MO)
- Digestive Health Specialists (WA)
- Greater Austin Allergy, Asthma and Immunology (TX)
- Halifax Regional Cardiology (NC)
- HealthPoint Medical Group - Hematology and Oncology (FL)
- Hematology Oncology Associates of Central New York (NY)
- Immune Deficiency Clinic, Kaiser Permanente Northwest (OR)
- Jefferson Medical Oncology Associates (PA)
- Jefferson Pulmonary Associates (PA)
- Johns Hopkins Community Physicians - Heart Care (MD)
- Joslin Diabetes Center - Harvard (MA)
- Joslin Diabetes Center Affiliate at Southview Medical Center (OH)
- Lankenau Clinical Care Center (PA)
- Main Line Gastroenterology Associates (PA)
- Medical Associates of the Hudson Valley (NY)
- MomDoc (AZ)
- New Mexico Heart Institute (NM)
- North Country Obstetrics and Gynecology (VT)
- North Texas Kidney Disease Associates (TX)
- Northeast Indiana Urology (IN)
- Occupational and Environmental Medicine, Dartmouth Hitchcock Medical Center (NH)
- Ohio State University Rheumatology at CarePoint East (OH)
- Orlando Heart Specialists (FL)
- OSUCCC-James Physician Group (OH)
- PMA Medical Specialists (PA)
- PMSI - Division of Neurology (PA)
- Providence Heart Clinic at The Oregon Clinic Gateway (OR)
- Pulmonary Clinic of the Carolinas (NC)
- Raleigh OB/Gyn Centre (NC)
- Scarsdale Medical Group (NY)
- Sea Island Pediatrics (SC)
- South Penn Eye Care (PA)
- St. Clair Specialty Physicians (MI)
- Texas Children's Health Plan - The Center, The Center at Greenspoint - Obstetrics Clinic (TX)
- Texas Health Physicians Group (TX)
- Texas Oncology-Methodist Dallas Cancer Center (TX)
- The Davies Medical Group-Mental Health Specialists (CA)
- The Sleep Lab - Jamil Sulieman MD (HI)
- The University of Kansas Physicians - Department of Internal Medicine (KS)
- The West Clinic (TN)
- Thomas Jefferson University - Liver Transplant Program (PA)
- Toledo Clinic Cancer Centers (OH)
- TriState Hospital and Medical Clinic (WA)
- University of Florida College of Medicine, Department of Pediatrics, Division of Infectious Diseases and Immunology, College of Medicine-Jacksonville (FL)
- University of Rochester Medical Center (URMC) Women's Health Practice at Lattimore (NY)
- Wellmont CVA Heart Institute (TN)
- Wendover OB/GYN & Infertility (NC)
- Western Connecticut Medical Group Cardiovascular Services (CT)
- Western Slope Endocrinology (CO)
- Wishard Health Services (IN)
- Women's Healthcare Associates (OR)
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.