Renewal Requirements

To acknowledge that practices with Level 2 or Level 3 Recognition have taken steps toward practice redesign and have systems in place that support their recognition level, NCQA offers a streamlined process for renewal through reduced documentation requirements. Practices that satisfactorily demonstrated basic medical home transformation can focus on more advanced aspects of redesign for their renewal applications. Renewal for Level 1 requires a full survey.

Multi-site organizations with practices that have achieved PCMH 2014 Level 2 or Level 3 Recognition are eligible to renew by completing the entire survey but it is only necessary to attach documentation for a limited number of specific elements. Multi-sites, see your requirements for PCMH 2014 renewal.

Although some elements do not require submission of documentation, organizations/practice sites must be able to provide documentation if they are selected for audit.

Only the following elements require documentation for renewals for the streamlined process:

Renewing under:

PCMH 2014: 1A*, 2D*, 3C, 3D*, 4A, 4B*, 4C, 5B*, 6B, 6D*, 6E

* Indicates a MUST-PASS element

For all remaining elements for factors answered “Yes,” you must attest to the language below, and you must implement those factors.  To attest, indicate the elements on the "Renewal Elements" tab of the Organization Background section of your ISS survey tool.

"Our practice achieved Level 2 or Level 3 Recognition as a patient-centered medical home and attests that the responses to the factors of this element reflect the current operation of the organization/practice sites. Documentation to support these responses can be provided upon request."

The two tables that follow list all elements that require responses from the practice to renew under PCMH 2011 or PCMH 2014.

Table for Renewal Under PCMH 2014

Points

PCMH 2014 Standards and Elements

Documentation or Attestation?

10

PCMH 1: Patient-Centered Access                                                      

 

4.5

PCMH 1A: Patient-Centered Appointment Access 

MUST-PASS

Documentation

3.5

PCMH 1B: 24/7 Access to Clinical Advice                                        

Attestation

2

PCMH 1C: Electronic Access                                                             

Attestation

12

PCMH 2: Team-Based Care                       

 

3

PCMH 2A: Continuity                                                                           

Attestation

2.5

PCMH 2B: Medical Home Responsibilities                                           

Attestation

2.5

PCMH 2C: Culturally and Linguistically Appropriate Services (CLAS)  

Attestation

4

PCMH 2D: The Practice Team                                                             MUST-PASS

Documentation

20

PCMH 3: Population Health Management

 

3

PCMH 3A: Patient Information                                                                        

Attestation

4

PCMH 3B: Clinical Data                                                                    

Attestation

4

PCMH 3C: Comprehensive Health Assessment                                      

Documentation

5

PCMH 3D: Use Data for Population Management                      

MUST-PASS

Documentation

4

PCMH 3E: Implement Evidence-Based Decision-Support                       

Attestation

20

PCMH 4: Care Management and Support

 

4

PCMH 4A: Identify Patients for Care Management                                        

Documentation

4

PCMH 4B: Care Planning and Self-Care Support            

MUST-PASS

Documentation

4

PCMH 4C: Medication Management                                                           

Documentation

3

PCMH 4D: Use Electronic Prescribing                                                          

Attestation

5

4E: Support Self-Care and Shared Decision-Making                 

Attestation

18

PCMH 5: Care Coordination and Care Transitions

 

6

5A: Test Tracking and Follow-Up                                                  

Attestation

6

5B: Referral Tracking and Follow-Up                                               

MUST- PASS

Documentation

6

5C: Coordinate Care Transitions                                          

Attestation

20

PCMH 6: Performance Measurement and Quality Improvement

3

6A: Measure Clinical Quality Performance                                

Attestation

3

6B: Measure Resource Use and Care Coordination                       

Documentation

4

6C: Measure Patient/Family Experience                                       

Attestation

4

6D: Implement Continuous Quality Improvement                      

MUST-PASS

Documentation

3

6E: Demonstrate Continuous Quality Improvement              

Documentation

3

6F: Report Performance                                                                

Attestation  

0

6G: Use Certified EHR Technology

N/A

Attestation – 15 Elements

Documentation – 11 Elements

N/A – 1