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Recognition Redesign Annual Reporting

Practices will use the online platform to submit documentation that supports reporting requirements at their annual check-in; NCQA reviews documentation and notifies practices of their sustained recognition status. Sustained recognition will be based on a practice’s overall performance across six categories. Practices must meet the minimum number of requirements for each category. NCQA will randomly select practices for audit to validate submitted documentation and data. 

Practices will demonstrate they continue to align with recognition requirements by submitting data and documentation on these six critical aspects of PCMH: 

  1. Patient-centered access. 
  2. Team-based care. 
  3. Population health management. 
  4. Care management. 
  5. Care coordination and care transitions. 
  6. Performance Measurement and Quality Improvement

Annual Reporting: Accepted Measures 

NCQA maintains a list of measures accepted as a future part of, or alternative to, the annual reporting process. 

Quality Measures Crosswalk
This document represents a crosswalk chart of the quality measures that NCQA will include in its 2017 PCMH recognition program. It provides a crosswalk among the measures that are used to support HEDIS reporting, as well as to support payment incentive programs such as MACRA. In addition, the chart identifies the measures that NCQA offers certification to vendors seeking validation that their quality measures reporting capabilities meet the CMS reporting specifications. This list will be updated periodically.
Last Updated: December 7, 2016