Delivery System Reform

Many efforts are underway to deliver higher quality health care at lower costs.

Patient Centered Medical Home

NCQA is at the forefront of these efforts with rigorous programs to make sure these delivery system reforms protect consumers and deliver results. NCQA’s Patient-Centered Medical Home Recognition Program helps to transform primary care into what patients like you want it to be. That includes:

• Enhanced access to care through expanded hours, online communication and long-term partnerships with clinicians, instead of a disconnected series of sporadic, hurried visits.
• Clinician-led teams coordinate care, especially for prevention and chronic conditions, as well as with other clinicians and community supports.
• You make shared decisions with your providers for more informed choices and better results.

More Information:

• NCQA Comments on House Ways and Means and Energy And Commerce Committees' Proposal to Reform the Sustainable Growth Rate
• PCMH Fact Sheet 
• There is a growing body of scientific evidence that Patient-Centered Medical Homes improve quality while lower costs. These include: 
  • PCMH Improves Low-income Access, Reduces Inequities Berenson, Commonwealth Fund, May 2012  
  • Community Care of North Carolina $1B Savings Milliman, January 2012 
  • Cigna’s Collaborative Accountable Care Program Shows Improved Quality, Lower Costs August 2011 
  • Reinventing Medicaid: State Innovations To Qualify And Pay For PCMHs Show Promising Results Takach, Health Affairs, July 2011 
  • The Group Health Medical Home At Year Two: Cost Savings, Higher Patient Satisfaction and Less Burnout For Providers Soman, Health Affairs, May 2010 
  • Reduced hospitalization/ER visits, overall savings Fields, Health Affairs, May 2010 (Abstract only; full article available to Health Affairs subscribers.)
• NCQA's PCMH program is fully aligned with federal incentives for 'meaningful use' of health information technology. For details, please see our NCQA PCMH-Meaningful Use Crosswalk and Graphic
• Health IT Meaningful Use & NCQA Patient-Centered Medical Home Alignment
• NCQA is encouraging Congress and Medicare to incorporate Patient-Centered Medical Homes and other delivery system reforms into Medicare's physician payment policies. For details, please see: NCQA Medicare Physician Fee Schedule Comments 
• NCQA Patient-Centered Medical Home Program page 

Patient-Centered Specialty Practice Recognition

NCQA is building on the PCMH success to improve care coordination with specialist physicians. Our new Patient-Centered Specialty Practice Recognition Program launches in March of 2013 to address gaps in quality that occur because of poor coordination between primary and specialty providers.

More Information: