The PCMH Recognition Process

To become an NCQA-Recognized Patient-Centered Medical Home (PCMH), a primary care practice learns the NCQA PCMH concepts and required criteria and begins the transformation process. NCQA conducts online check-ins to assess the practice’s progress and discuss the next steps in the evaluation.  A practice that meets the criteria earns NCQA Recognition.

Commit

  1. Learn the Requirements

    Review the PCMH Concepts Overview and download the NCQA Standards and Guidelines document.

    Begin learning the concept areas and required criteria.

    Review our online and in-person training, which can help you better understand the recognition process and requirements.

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  2. Apply Concepts To Your Practice

    Implement changes in your practice that align with the PCMH concepts.

  3. Enroll

    When you are familiar with the concepts and have started to transform, create a QPASS account at qpass.ncqa.org

    Complete an initial questionnaire and pay your enrollment fee.

    Learn more about the steps to enroll and what is required at enrollment.

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Transform

  1. Kick-Off Call

    Once enrolled, NCQA assigns a representative to guide your practice through the recognition process.

    Your Representative will schedule an initial call to introduce themselves, discuss the process and develop a review schedule of up to three check-ins over the course of your transformation work.

    If you have more than one site, your representative can provide you guidance on setting up site groups and sharing evidence across sites.

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  2. Apply PCMH Criteria to the Practice

    Implement changes in your practice that align with PCMH criteria.

    Decide which requirements you want to submit and how you want to demonstrate evidence.

    Use Q-PASS to upload evidence (such as policies and procedures). You may demonstrate other requirements in real time during the virtual review through screen-sharing technology. Screen-sharing technology eliminates the need to upload documentation in advance.

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  3. Virtual Reviews

    Practices have up to 3 virtual reviews using screen-sharing technology.

    Virtual reviews allow you to share your screen to show you meet NCQA PCMH requirements instead of submitting documentation.

    Virtual reviews give immediate and personalized feedback on what is going well and what needs to improve. Learn what to expect during the virtual review.

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Succeed

  1. Submit for Recognition

    Submit for Recognition through Q-PASS.

    After virtual reviews are complete and you have met enough criteria to earn PCMH Recognition, submit for Recognition through Q-PASS.

     

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  2. Earn Recognition

    NCQA reviews the submission one last time and notifies practices of their recognition status.

    Once notified of recognition, practices go into Q-PASS and print their Recognition Certificate.

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  3. Annual Reporting

    Your practice performs ongoing quality improvement.

    Your practice submits evidence of this to NCQA during Annual Reporting to sustain recognition and succeed as a PCMH recognized practice.

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