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.

PCMH 2014 Conversion vs. Streamlined Renewal Requirements

Conversion vs. Streamlined Renewal Requirements for PCMH 2014

Both streamlined renewal and conversion reduce documentation burden for practices but are very different processes. Conversion allows a practice with a current PCMH 2011 recognition to “convert” to a PCMH 2014 recognition and add 1 year to their current recognition end date (e.g., a practice with June 1, 2016 end date would extend recognition until June 1, 2017). The streamlined renewal process (for practices currently recognized as PCMH level 2 or 3) is for practices with an expiring recognition who are renewing for another three-year recognition period. The only program available for renewal at this time is PCMH 2014 (e.g., a practice with an expiring PCMH 2011 recognition would renew using the PCMH 2014 streamlined renewal requirements). 

The table below highlights the major differences in documentation between the two processes. Please note that for all elements not requiring documentation, the practice may attest. Yes and no responses must reflect current processes and procedures, and practices are required to provide documentation in the case of an audit.

 

    Documentation Required?
Points PCMH 2014 Standards and Elements Conversion Requirement Renewal Requirement
10 PCMH 1: Patient-Centered Access
4.5 A     Patient-Centered Appointment Access MUST PASS  Yes  Yes
3.5 B     24/7 Access to Clinical Advice No No
2 C     Electronic Access No No
12 PCMH 2: Team-Based Care
3 A     Continuity No No
2.5 B     Medical Home Responsibilities No No
2.5 C     Culturally and Linguistically Appropriate Services (CLAS) No No
4 D     The Practice  Team MUST-PASS Yes Yes
20 PCMH 3: Population Health Management
3 A     Patient Information No No
4 B     Clinical Data No No
4 C     Comprehensive Health Assessment No Yes
5 D     Use Data for Population Management MUST-PASS No Yes
4 E     Implement Evidence-Based Decision Support Yes No
20 PCMH 4: Care Management and Support
4 A     Identify Patients for Care Management Yes Yes
4 B     Care Planning and Self-Care Support MUST-PASS Yes
(examples only)
Yes
4 C     Medication Management No Yes
3 D     Use Electronic Prescribing No No
5 E     Support Self-Care and Shared Decision-Making No No
18 PCMH 5: Care Coordination and Care Transitions
6 A     Test Tracking and Follow-Up No No
6 B     Referral Tracking and Follow-Up MUST-PASS No Yes
6 C     Coordinate Care Transitions No No
20 PCMH 6: Performance Measurement and Quality Improvement
3 A     Measure Clinical Quality Performance No No
3 B     Measure Resource Use and Care Coordination Yes Yes
4 C     Measure Patient/Family Experience No No
4 D     Implement Continuous Quality Improvement MUST-PASS No Yes
3 E     Demonstrate Continuous Quality Improvement No Yes
3 F     Report Performance No No
0 G     Use Certified EHR Technology NA NA
  Total Elements Total Elements
    6 11