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Patient-Centered Specialty Practice (PCSP) 2016 

Multi-Site (Single- or Multi-Specialty) Renewal Requirements

 

To acknowledge that practices with Level 2 or Level 3 Recognition have taken significant 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.

Practices that have achieved PCSP 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. Single-sites, see your requirements for PCSP 2016 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 PCSP 2016: 1A, 1D, 1E, 1F, 2A, 2E, 3D, 5A, 5B, 5C, 6A, 6C 

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 specialty practice 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 table below lists all elements that require responses from the practice to renew under PCSP 2016.

 

[6 standards, 26 elements, 164 factors]

Documentation

Multi-Site Practices

PCSP 1: Working with Primary Care and Other Referring Clinicians

Corporate-Eligible or Site-Specific?

Documentation or Attestation?

Element A: Working With Primary Care

Corporate-Eligible

Documentation

Element B: Managing Initial Referrals MUST-PASS

Corporate-Eligible

Attestation

Element C: Assessing Initial Referral Content

Corporate-Eligible

Attestation

Element D: Assessing Initial Referral Response MUST-PASS

Site-Specific (by specialty)*

Documentation

Element E: Transition Back to Primary Care

Site-Specific (by specialty)*

Documentation

Element F: Connecting Self-Referred Patients With Primary Care

Corporate-Eligible

Documentation

PCSP 2: Provide Access and Communication

 

Element A: Access

Corporate-Eligible

Documentation

Element B: Electronic Access

Corporate-Eligible

Attestation

Element C: Specialty Practice Responsibilities

Corporate-Eligible

Attestation

Element D: Culturally & Linguistically Appropriate Services. (CLAS)

Corporate-Eligible

Attestation

Element E: The Practice Team MUST-PASS

Site-Specific (by specialty)*

Documentation

PCSP 3: Identify and Coordinate Patient Populations

 

 

Element A: Patient Information

Corporate-Eligible

Attestation

Element B: Clinical Data

Corporate-Eligible

Attestation

Element C: Coordinate Patient Populations

Corporate-Eligible (by specialty)*

Attestation

Element D: Implement Evidence-Based Decision Support

Corporate-Eligible (by specialty)*

Documentation

PCSP 4: Plan and Manage Care

 

 

Element A: Care Planning and Support Self-Care

Site-Specific (by specialty)*

Attestation

Element B: Medication Management MUST-PASS

Site-Specific (by specialty)*

Attestation

Element C: Use Electronic Prescribing

Corporate-Eligible

Attestation

PCSP 5: Track and Coordinate Care

 

 

Element A: Test Tracking and Follow-up MUST-PASS

Corporate-Eligible

Documentation

Element B: Referral Tracking and Follow-up

Corporate-Eligible

Documentation

Element C: Coordinate Care Transitions

Corporate-Eligible (by specialty)*

Documentation

PCSP 6: Measure and Improve Performance

 

 

Element A: Measure Performance

Corporate-Eligible (by site and specialty)**

Documentation

Element B: Measure Patient/Family Experience

Corporate-Eligible (by site)

Attestation

Element C: Implement & Demonstrate Continuous QI MUST-PASS

Site-Specific (by specialty)*

Documentation

Element D: Report Performance

Corporate-Eligible

Attestation

Element E: Use Certified EHR Technology

Corporate-Eligible

Attestation

TOTAL

Corporate – 20

Site-specific – 6

 

*10 elements by Specialty

Documentation – 12

Attestation – 14

 

Documentation by specialty: 

• *For practices with two (2) specialties at one (1) site, documentation must be provided for both specialties.
**Each specialty must submit a report for 6A, Factor 1 that includes data for 3 clinical measures. 

• *For practices with three (3) or more specialties at one site, documentation must be provided for three (3) specialties including: 1) largest specialty, represented by the number of patient visits and 2) behavioral health, if included in the types of specialties.
**Each specialty must submit a report for 6A, Factor 1 that includes data for 3 clinical measures. 

• A documented process that is the same for all specialties at the site may be provided once to NCQA.