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Patient-Centered Specialty Practice (PCSP) 2016 

Single 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. Multi-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 or Attestation?

PCSP 1: Working with Primary Care and Other Referring Clinicians

 

Element A: Working With Primary Care

Documentation

Element B: Managing Initial Referrals MUST-PASS

Attestation

Element C: Assessing Initial Referral Content

Attestation

Element D: Assessing Initial Referral Response MUST-PASS

Documentation*

Element E: Transition Back to Primary Care

Documentation*

Element F: Connecting Self-Referred Patients With Primary Care

Documentation

PCSP 2: Provide Access and Communication

 

Element A: Access

Documentation

Element B: Electronic Access

Attestation

Element C: Specialty Practice Responsibilities

Attestation

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

Attestation

Element E: The Practice Team MUST-PASS

Documentation*

PCSP 3: Identify and Coordinate Patient Populations

 

Element A: Patient Information

Attestation

Element B: Clinical Data

Attestation

Element C: Reminders for Specialty Care

Attestation*

Element D: Implement Evidence-Based Decision Support

Documentation*

PCSP 4: Plan and Manage Care

 

Element A: Care Planning and Support Self-Care

Attestation*

Element B: Medication Management MUST-PASS

Attestation*

Element C: Use Electronic Prescribing

Attestation

PCSP 5: Track and Coordinate Care

 

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

Documentation

Element B: Referral Tracking and Follow-up

Documentation

Element C: Coordinate Care Transitions

Documentation*

PCSP 6: Measure and Improve Performance

 

Element A: Measure Performance

Documentation**

Element B: Measure Patient/Family Experience

Attestation

Element C: Implement & Demonstrate Continuous QI MUST-PASS

Documentation*

Element D: Report Performance

Attestation

Element E: Use Certified EHR Technology

Attestation

TOTAL

Documentation – 12

Attestation – 14

 

*If a single site, multi-specialty: 

(1) For “documentation,” the site must submit documentation by specialty.
(2) For “attestation,” the site must be able to submit documentation by specialty IF audited. 

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.