Connect with NCQA

twitter linkedin facebook google+ youtube pinterest

Report an Error

Use NCQA’s Feedback Form to report a broken link, or content error.

Patient-Centered Connected Care™ Frequently Asked Questions

What is the Patient-Centered Connected CareTM Program?

Patient-Centered Connected Care recognition evaluates how ambulatory care providers – such as urgent care centers, onsite employee health clinics and school- and retail- based clinics -- communicate and connect with primary care providers as they deliver care to shared patients. It creates a roadmap for how sites delivering intermittent or outpatient treatment—but do not act as a primary care provider for a majority of its patients—can fit into the medical home “neighborhood.” Sites that demonstrate they follow NCQA Patient-Centered Connected Care standards are positioned to earn an NCQA seal.

Why was this program created?

Over the years, the health care delivery system has become more fragmented. Some people may not have a primary care practitioner who manages and tracks their care, and many people seek care in locations that are not necessarily associated with their primary care practitioner. This creates fragmented care and a sub-optimal patient experience. This program was created to help reduce that fragmentation.

In addition, value is important in the health care system. Payers, employers and states are increasingly rewarding practitioners who provide improved patient care and cost savings. The patient-centered medical home (PCMH) model of care—one in which care is centrally coordinated and tracked by one primary care provider—has become the standard by which primary care can achieve better patient care and lower costs. The Patient-Centered Connected Care Recognition Program aligns with that model and is another step in creating more integrated care.

What are the requirements?

Sites that want to become recognized must meet a minimum score across five different standards. Within the standards there are a number of elements and factors that must be met. Some of these elements are “must-pass” elements, meaning a site must receive a minimum score on them to gain recognition.

To order the Standards & Guidelines, visit store.ncqa.org and look for the Patient-Centered Connected Care Standards & Guidelines under the “Recognition” section.

The five standards look at:

  • Connecting With Primary Care: The site connects with and shares information with primary care providers.
  • Identifying Patient Needs: The site directs patients to appropriate providers, when necessary.
  • Patient Care and Support: The site uses evidence-based decision support in care delivery, collaborates with patients to make care decisions and delivers culturally and linguistically appropriate services.
  • System Capabilities: The site uses electronic systems to collect data and execute tasks.
  • Measure and Improve Performance: The site systematically monitors performance and carries out activities to improve clinical outcomes and patient experience.

What is the process for becoming recognized?

Practice sites must score a minimum on a set of standards through a survey process that involves submitting documentation to NCQA. Some sites may also be reviewed through an on-site visit. Below is a high-level overview of the major steps in becoming recognized.

  • Purchase Standards & Guidelines: The Patient-Centered Connected CareTMstandards and guidelines detail program requirements and the documentation required to become recognized.
  • Access Online Application & Complete Eligibility Check: The eligibility check kicks off the recognition process. Access the online application here.
  • Learn Standards & Transform Site: NCQA education seminars help familiarize you with the standards and prepare you for the survey process. Use these standards to transform your site to meet the requirements.
  • Purchase and the Survey Tool(s): The survey tool will be used to submit documentation. Multiple sites with different systems or policies/procedures may need more than one Survey Tool.
  • Submit the Application, Schedule Survey Date(s): When you are ready to be reviewed by NCQA, submit the final application, schedule your survey date and pay your application fee.
  • Submit Completed Survey: Use the online Survey Tool to submit the completed survey and documentation. Also, pay your survey fee at this time.
  • Onsite Survey (if applicable): Your site may be scheduled for an onsite review. Onsite reviews are conducted following the review of written documentation.
  • Receive Decision: In general, you will receive your survey results within 60 days of your survey and learn whether you are the newest NCQA-Recognized Patient-Centered Connected Care site.

How much does Recognition cost?

To bring your site through recognition you will purchase the Standards & Guidelines document, which contains the requirements for achieving recognition, as well as the survey tool, which you use to submit your documentation. Then, there is a cost for each site you submit a survey for. There are pricing breaks once you hit 51 sites, and again after you hit 501 sites, to lower the cost. 

# of Sites

Cost Per Site Per Recognizable Entity

Sites 1-50

$1,500 ea.

51-500

$750 ea.

501+

Free



Pricing for Standards & Guidelines and Survey Tool

 

Single User

2-4 Users 5-10 Users 11-20 Users

Standards & Guidelines

$50

$140 $330 $600

ISS Survey Tool

$80

$220 $520 $960

How long does Recognition last?

Your recognition will last for three years.

What if we have multiple sites?

You can, and are encouraged, to bring multiple sites through recognition. If all sites follow the same processes, procedures and use the same EHR system, then you likely only need to purchase one survey tool. If they operate off of different EHR systems or have different key processes and procedures, then they will will likely be categorized as multiple eligible entities and need multiple survey tools. This will be determined at the eligibility check stage of applying for recognition.

Can we bring sites through Recognition at different times?

Yes. This is called an “expansion survey”. You can bring through sites at different times and you will not have to purchase a new survey tool. The pricing and process varies depending on how many sites you bring through, when you bring those sites through and whether they count as different eligible entities. Please speak with an NCQA representative for more information on the process and pricing.

Are there different levels of Recognition like there are for PCMH?

No. Sites are either recognized or not recognized. There are not different levels.

What are the benefits to becoming recognized?

NCQA’s Patient-Centered Connected Care Recognition Program contains best practices for sites to follow and affirms they effectively connect with primary care for improved patient-centered care delivery.

  • Produce better outcomes. Create healthier patients by working within the medical home neighborhood model of care, which has been shown to reduce health care costs and result in better outcomes for patients
  • Create happier patients. Provide a better patient experience by connecting patients to the right resources, at the right time
  • Improve operations. Enhance current processes and procedures by evaluating them against best practices and striving for continuous improvement
  • Demonstrate value. Public and private payers are looking for cost containment and quality improvement activities that reduce fragmentation to be used in value-based benefit design Show these partners you have a strong commitment to quality, patient-centered care.
  • Increase referrals. Demonstrate to PCP practices that you are ready to be effective partners in caring for shared patients · Market to patients. Leverage NCQA Seal and validation to demonstrate to patients you are a trusted source for their care (benefits for marketing your business)
  • Elevate your reputation. You’ll gain national exposure as a first-mover into an unchartered program devised by a leader in development of nationally endorsed quality programs

Where can I access a copy of the standards and guidelines?

You can purchase the standards and guidelines at store.ncqa.org under the “Recognition” section of the site.

Will you visit my site as part of the recognition process?

Not all sites will receive an on-site visit, but your site may be chosen for an on-site visit as part of the recognition process. You will be notified if you are required to have an on-site visit during the eligibility check. The on-site visit will be scheduled after you submit your final application for recognition.