NCQA PCMH Recognition: Better Quality. Lower Costs.
Research shows NCQA PCMH Recognition improves patient care and reduces costs. In addition, the PCMH model is associated with happier staff and happier patients, important for patient satisfaction scores.
Benefits For Practices
- Align with where health care is headed. Payers continue to move from the fee-for-service model towards rewarding integration and quality care. They are increasingly contracting with organizations that can show they have a strong infrastructure and quality improvement initiatives. NCQA PCMH Recognition prepares you to succeed.
- Integrate services across your entire organization. If you are a health system or clinically integrated network with specialty practices, urgent care centers and other types of practice sites, NCQA’s Patient-Centered Specialty Practice (PCSP) and Patient-Centered Connected Care programs mean your whole organization can evolve into a high-functioning medical home neighborhood. These other programs are built off of the PCMH model and complement NCQA PCMH Recognition.
- Support revenue growth. Many Federal, state and commercial payers offer incentive programs to practices that achieve NCQA PCMH/PCSP Recognition.
- Improve your practice. Use NCQA PCMH Recognition to perform gap analyses and to implement processes and procedures that improve care for patients and make your practice more efficient.
- Keep staff happy. The PCMH model helps streamline processes and standardize procedures that keep practice staff at the top of their knowledge, skills and ability. It has been shown to result in higher staff satisfaction.1
- Market your practice. NCQA publishes a list of all recognized practices and clinicians in its Recognition Directory. Use the NCQA seal to market your accomplishment to patients and partners. We can even help you distribute a press release to local press, touting your achievement.
Benefits For Clinicians
- Earn higher reimbursement. More than 100 payers nationwide offer either enhanced reimbursement for recognized clinicians or support for practices to become recognized.
- Succeed in MACRA. The Centers for Medicare & Medicaid Services (CMS) acknowledges both NCQA’s PCMH and PCSP Recognition programs as ways to receive MACRA credit. Clinicians in NCQA-Recognized PCMHs/PCSPs automatically earn full credit in the MIPS Improvement Activities category, and are likely to do well in other MIPS categories. The PCSP Recognition program is the only specialty-focused evaluation program in the country recognized by CMS in MACRA.
- Earn Maintenance of Certification (MOC) credits. Several medical boards award clinicians in NCQA-recognized practices Maintenance of Certification (MOC) credits, reducing the burden on clinicians to take on additional activities.
- Focus on patient care. The PCMH model ensures that team members operate at the highest level of their knowledge, skills, abilities and license, within their assigned roles and responsibilities.
Benefits For Patients
- Stay healthy. Patients who are treated in PCMHs tend to receive preventive services and screenings at a higher rate than patients who are not in PCMHs, helping them stay healthy.
- Better communication. Communication with patients and their families/caregivers is a core concept of the PCMH model, which also emphasizes enhanced patient access to clinical advice and medical records.
- Better management of chronic conditions. According to research, PCMHs are especially helpful for patients with complex chronic conditions.
- Have a better experience. When medical home attributes are described to people, they say it is the type of care they want to receive.
1 Lewis, S.E., R.S. Nocon, H. Tang, S.Y. Park, A.M. Vable, L.P. Casalino, E.S. Huang, M.T. Quinn, D.L. Burnet, W.T. Summerfelt, J.M. Birnberg, M.H. Chin. 2012. “Patient-Centered Medical Home Characteristics and Staff Morale in Safety Net Clinics.” Arch Intern Med 172(1):23–31.