|Practices do this...
||• Assess to determine priorities and capabilities for transformation based on current clinical practices and resources.
• Commit with NCQA to pursue transformation and recognition as an NCQA PCMH.
• Complete an online guided assessment.
• Work with an assigned NCQA representative to develop an evaluation schedule, identify support and education for transformation.
• Review new NCQA online education resources designed to support transformation.
|• Implement changes necessary to transform into a PCMH.
• Submit initial documentation and review in an online, virtual check-in session with an NCQA evaluator.
• Participate in two additional virtual check-ins with an NCQA evaluator to submit documentation, confirm progress and accumulate credits toward recognition.
• Earn NCQA PCMH Recognition after demonstrating transformation.
|• Sustain current PCMH activities and continue to evolve as a medical home and improve patient care.
• Implement activities to meet new PCMH requirements, when necessary.
• Perform an annual check-in with NCQA to verify continued success as a PCMH; submit documentation according to reporting requirements.
• Earn another year of Recognition as an NCQA PCMH.
|While NCQA does this...
|| • Provides information and resources to assist in the practice’s decision-making process to pursue transformation and NCQA Recognition.
• Answers all questions and addresses concerns leading up to the practice’s decision to commit to transformation.
• Assigns a representative to the practice as its primary point of contact at NCQA.
• Gives the practice access to an online self-assessment.
• Works with the practice to develop an evaluation schedule.
• Identifies resources and education to support the practice’s transformation.
|• (Representative) Monitors the practice’s transformation progress.
• (Representative) Reaches out to practices (or to their Certified Content Expert) whose transformation is slower than expected, to discuss possible barriers and recommend resources and education opportunities to resolve them.
• Assigns an evaluator to conduct the recognition review.
• (Evaluator) Conducts three virtual check-ins to ascertain whether the practice is transforming and meeting PCMH recognition requirements.
• Reviews the practice’s final submission and forwards it to the NCQA Peer Review Committee for evaluation and confirmation of initial approval.
• Notifies the practice of its recognition status.
| • Conducts an annual check-in to confirm that the practice continues ongoing transformation activities.
• Notes and documents practice changes (i.e., new clinician, new site address) at the annual review.
• Evaluates the practice’s submitted data and documentation that demonstrate continued transformation.
• Audits a random sample of practice submissions to verify that PCMH requirements and guidelines are being met over time (focusing on areas addressed through practice attestation in the annual reporting requirements).