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Patient-Centered Specialty Practice (PCSP) 2016

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

[6 standards, 26 elements, 164 factors]

Documentation

Multi-Site Practices

PCSP 1: Working With Primary Care and Other Referring Clinicians

Document Once in Corporate Survey Tool

Provide for Each Practice Site

Element A: Establishing Relationships with Primary Care and Other Referring Clinicians

X

 

Element B: Managing Initial Referrals (MUST-PASS)

X

 

Element C: Assessing Initial Referral Content

X

 

Element D: Assessing Initial Referral Response (MUST-PASS)

 

X (by Specialty)*

Element E: Transitions Back to Primary Care

 

X (by Specialty)*

Element F: Connecting Self-Referred Patients with Primary Care

X

 

PCSP 2: Provide Access and Communication

 

Element A: Access

X

 

Element B: Electronic Access

X

 

Element C: Specialty Practice Responsibilities

X

 

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

X

 

Element E: The Practice Team (MUST-PASS)

 

X (by Specialty)*

PCSP 3: Identify and Coordinate Patient Populations

 

Element A: Patient Information

X

 

Element B: Clinical Data

X

 

Element C: Implement Evidence-Based Reminders for Specialty Care

X (by Specialty)*

 

Element D: Implement Evidence-Based Decision Support

X (by Specialty)*

 

PCSP 4: Plan and Manage Care

 

 

Element A: Care Planning and Support Self-Care

 

X (by Specialty)*

Element B: Medication Management (MUST-PASS)

 

X (by Specialty)*

Element C: Use Electronic Prescribing

X

 

PCSP 5: Track and Coordinate Care

 

 

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

X

 

Element B: Referral Tracking and Follow-up

X

 

Element C: Coordinate Care Transitions

X (by Specialty)*

 

PCSP 6: Measure and Improve Performance

 x

Element A: Measure Performance

X (by Site and by Specialty)**

 

Element B: Measure Patient/Family Experience

X (by Site)

 

Element C: Implement & Demonstrate Continuous QI
(MUST-PASS)

 

X (by Specialty)*

Element D: Report Performance

X

 

Element E: Use Certified EHR Technology

X

 

TOTAL

20 Elements

· 4 elements by Specialty

· 2 elements by site

6 Elements

· 6 elements by Specialty




Documentation by specialty for the corporate survey tool:

  • *For organizations with two (2) specialties, documentation must be provided for both specialties.

    X** - If an organization elects to report Element 6A in the corporate survey tool, it must report three clinical measures for each specialty AND by site location for 6A, Factor 1.

  • *For organizations with three (3) or more specialties, documentation must be provided for three (3) specialties including 1) largest specialty, represented by number of patient visits, and 2) behavioral health, if included as a specialty.

     X** - If an organization elects to report Element 6A in the corporate survey tool, it must report three clinical measures for each specialty AND by site location for 6A, Factor 1.

  • Documented processes that are the same for all specialties may be provided once to NCQA.

Documentation by specialty for each practice site:

  • *For practices with two (2) specialties at one (1) site, documentation must be provided for both specialties.

    X** - A report with three clinical measures must be provided for each specialty for 6A, Factor 1.

  • *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 number of patient visits, and 2) behavioral health, if included as a specialty.

    X** - Practices with 3+ specialties, must report 3 measures for each of the 3 specialties being reported.

  • Documented processes that are the same for all specialties may be provided once to NCQA.