Auto Credit: Patient-Centered Medical Home (PCMH) 2011/2014 to Patient-Centered Specialty practice (PCSP) 2013 Policy, FAQs and Selected Elements and Factors

Policy, FAQs and Selected Elements and Factors

~ How can practices use PCMH Recognition toward PCSP Recognition? ~

POLICY

1. Organizations with both primary care and specialty practices and that have practices with PCMH Level 2 or Level 3 Recognition may use auto credit from that recognition for selected elements in PCMH to streamline the Recognition process for PCSP 2013.  
2. To receive auto credit, PCMH and PCSP practices within the same organization must share the same electronic systems and use the same policies and procedures or documented processes. 

 

Frequently Asked Questions (FAQs) 
Question Answer
1. If a practice is applying for PCSP 2013 Recognition and is in the same organization as a practice with PCMH recognition, what auto-credit may be applied to PCSP?
1. The practice is allowed to attest to a maximum seven (7) elements from PCMH 2011 or 2014) in PCSP 2013. However, several factors within these seven elements are not available for auto credit because they are specific to PCSP, and not to PCMH, or they are required at the site level and must be reported for each practice site. 

(See the table below for details of the seven (7) elements and their associated factors)   

2. Is there a time limit? 2. Attestation for auto credit in a second Recognition must occur within the 3-year Recognition period but not within the last three (3) months of their Recognition.
3. Which elements are eligible for auto credit?  3. Seven (7) PCMH elements are eligible to be used as auto credit in PCSP:
  • For PCMH 2011, the elements are PCMH 1C, 1F, 2A, 2B, 3E, 5A, 6E.
  • For PCMH 2014, the elements are PCMH 1C, 2C, 3A, 3B, 4D, 5A, 6F.
  • Refer to the table below for a list of the elements that may be used for auto credit.
  • Please note that some factors within these elements cannot be used for auto credit.
4. What is the process for using the auto credit option?  4. The practice responds "yes" in the PCSP survey for the autocredit eligible factors and provides an attestation:
  • In the Organizational Background tab of the PCSP 2013 ISS survey tool, the practice will attest to the following for each eligible element: "[Name of practice] previously achieved NCQA Level 2 or Level 3 Recognition as a patient-centered medical home and attests that the responses to the eligible factors for this element reflect the current operations of the practice site. Documentation to support these responses can be provided on request."
  • The practice must be able to provide documentation for the auto credit elements if it is selected for audit.
5. Can any data or documentation be transferred from a PCMH Survey Tool to the new application PCSP?  5. No, NCQA is not able to transfer data from one type of Survey Tool to the other because of the differences in the Standards, Elements and Factors.

 

 [6 standards, 22 elements, 143 factors]
 

Multi-site  -- Multi-Specialty

PCMH 2011 PCMH 2014 Available for Auto Credit in PCSP 2013
   Auto Credit with Attestation
 PCSP 1: Track and Coordinate Referrals      
 Element A: Referral Process and Agreements (Must Pass)      
 Element B: Referral Content      
 Element C: Referral Response (Must Pass)      
 PCSP 2: Provide Access and Communication      
 Element A: Access      
 Element B: Electronic Access PCMH 1C PCMH 1C PCSP 2B
 Element C: Specialty Practice Responsibilities      
 Element D: Culturally & Linguistically Appropriate Services (CLAS) PCMH
1F
PCMH 2C PCSP 2D
 Element E: The Practice Team (Must Pass)      
 PCSP 3: Identify and Coordinate Patient Populations      
 Element A: Patient Identification PCMH 2A PCMH 3A PCSP 3A
PCMH 2011: Factors 1-8, 10-11
PCMH 2014: Factors 1-11. 13
 Element B: Clinical Data PCMH 2B PCMH 3B PCSP 3B
PCMH 2011: Factors 1-9
PCMH 2014: all factors
 Element C: Coordinate Patient Populations      
 PCSP 4: Plan and Manage Care      
 Element A: Care Planning and Support Self-Care      
 Element B: Medication Management (Must Pass)  

 Element C: Use Electronic Prescribing PCMH 3E PCMH 4D PCSP 4C
PCMH 2011: all factors
PCMH 2014: Factors 2-5
 PCSP 5: Track and Coordinate Care      
 Element A: Test Tracking and Follow-up PCMH 5A PCMH 5A PCSP 5A
PCMH 2011 & 2014: Factors 1, 3-11
No credit is given for this element without meeting Factor 2 as it is a new and *critical factor*
 Element B: Referral Tracking and Follow-up      
 Element C: Coordinate Care Transitions  

 PCSP 6: Measure and Improve Performance      
 Element A: Measure Performance      
 Element B: Measure Patient/Family Experience


 Element C: Implement & Demonstrate Continuous QI (Must Pass)      
 Element D: Report Performance PCMH 6E PCMH 6F PCSP 6D
 Element E: Use Certified EHR Technology      
 
7 PCMH elements may be used for auto credit
Some elements will be limited to specified factors

 

Updated 10/11/2016

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