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PCMH Recognition Program Redesign and Online Feedback

NCQA first developed the Patient-Centered Medical Home (PCMH) recognition program at the request of, and in collaboration with, four key medical professional societies - the American Academy of Pediatrics (AAP), the American College of Physicians (ACP), the American Osteopathic Association (AOA) and the American Academy of Family Physicians (AAFP). The effort was a response to growing demand from employers and payers for the means to identify practices that were delivering care aligned with the Joint Principles of the Patient-Centered Medical Home developed by these same societies.

Since the initial program was released in 2008, the NCQA PCMH program has gone through two substantial revisions, in 2011 and 2014. From the beginning, NCQA has relied on feedback from people in the field – those doing the work and receiving the care – to inform the evolution of the PCMH recognition program.

In response to the published literature critiques and recommendations we have received from the original framers of the Joint Principles, groups representing other clinicians, and the doctors, nurses, care coordinators and other team members that live the PCMH model every day, we are now planning an ambitious redesign of the program. The overarching objective of this redesign is to enhance the value of NCQA recognition programs for patients and their families, clinicians, employers, payers, and other stakeholders (such as federal and state agencies). Key components include:

  • Strengthening the link between recognition and practice performance on quality, cost, and patient experience metrics;
  • Increasing practice engagement while reducing non-value added work;
  • Leveraging practices’ investment in health information technology to help support PCMH recognition; and
  • Aligning PCMH recognition activities with other reporting requirements.

The following specific changes are being considered:

  • Providing more guidance to practices through new channels, including live support, online resources and improved customer service;
  • Offering a variety of educational activities to support practice transformation;
  • Reducing the documentation burden;
  • Introducing opportunities for virtual demonstration of processes;
  • Using information generated in the course of daily clinical care to support the recognition process;
  • Expanding our health IT pre-validation program so that practices can automatically attain points towards recognition;
  • Redesigning our online survey tool to be more user-friendly and efficient; and,
  • Engaging practices in a streamlined annual check-in rather than requiring a full documentation review every three years.
    • The new process will ask practices to demonstrate that the changes made during the initial recognition effort have been anchored in their day-to-day culture, and that they continue to enhance their patient-centered approach to care.

NCQA appreciates the challenges associated with the PCMH recognition process. We are enthusiastic about the positive feedback received to date regarding the redesign elements described above. And we are committed to continuing the dialogue, because we know that getting the redesign right will require the insights of our customers and other interested parties.

To this end, we will be providing regular updates on the process and soliciting input from everyone with a stake in the PCMH movement. In the meantime, if you have comments or suggestions you’d like to share on our current program, or the changes outlined above, we hope you’ll email us at ideas4pcmh@ncqa.org.

We look forward to the chance to enrich this vital program together.