Patient-Centered Specialty Practice Frequently Asked Questions

Q: What is the NCQA Patient-Centered Specialty Practice Recognition program? 

A: The PCSP recognition program for clinicians is designed to improve quality and reduce waste and poor patient experiences that result from poorly coordinated care. The program focuses on coordinating and sharing information among primary care clinicians and specialists. It requires clinicians to organize care around patients—across all clinicians seen by a patient—and to include patients and their families or other caregivers in planning care and as partners in managing conditions.

Q: Why is a specialist recognition program important?

A: This program recognizes specialty practices that successfully coordinate patient care and communicate with their primary care colleagues, other specialists and patients. Like NCQA’s Patient-Centered Medical Home (PCMH) program, PCSP recognition has specific expectations for providing timely access to care and continuous quality improvement. Practices who earn recognition have made a commitment to providing high quality patient-centered care.

Q: How did NCQA develop the PCSP program?

A: Development of the PCSP program followed the NCQA product development process and included use of a multi-stakeholder advisory committee, a literature review, public comment, targeted interviews with practices and beta-testing. NCQA drew from the work of the Agency for Healthcare Research and Quality and the American College of Physicians. PCSP standards were approved by the NCQA Board of Directors in December 2012, and PCSP 2013 was released in March 2013. An update of the program (PCSP 2016) was released in March 2016.

Q: What are the requirements for specialty practices?

A: The PCSP recognition requirements for PCSP 2013 and PCSP 2016 are available for download via the NCQA store

Q: How long will practices be able to submit using a PCSP 2013 survey tool?

A: The PCSP 2013 survey tool will be available for purchase until June 30, 2016, and NCQA will accept surveys until December 31, 2016. After that time, practices must submit using the PCSP 2016 survey tool. Please review the PCSP 2013-PCSP 2016 crosswalk to view the changes and learn more about the updated requirements for PCSP 2016.

Q: How do we verify our practice’s eligibility for PCSP recognition?

A: All practices are strongly encouraged to verify eligibility before beginning the application process!

The best way to determine eligibility is to consult the “Policies and Procedures” section of the free electronic publication, which outlines eligibility requirements, types of surveys and an overview of the survey process. More information can be found on the NCQA website, including a PCSP eligibility FAQ

All medical specialties (with the exception of primary care specialties where clinicians provide whole-person, patient-centered primary care for ≥75 percent or more of their patients) are included in PCSP recognition. If a site does not meet the criteria for PCSP or PCMH, it may want to consider reviewing the eligibility criteria for the Patient-Centered Connected Care recognition program.

An eligibility call is necessary for multiple specialties or multiple sites, but is not necessary for all surveys. The application is available online for download, free of charge.

Q: May our practice choose which clinicians to include?

A: No. Practices must include all eligible clinicians. Practices that seek recognition for a defined set of specialties must include every specialist practicing in the defined specialties.

Multi-site practices are eligible, but NCQA requires an eligibility screening call with NCQA staff before completing an application.

Q: I practice both as a primary care and a specialty physician. How do I determine which recognition program—PCMH or PCSP—is appropriate for my practice?

A: First, view the free, recorded Getting on Board trainings that provide an overview of program eligibility (the PCSP Standards Introduction recording also provides information regarding eligibility).  For specific questions, practices may attend the live, monthly “Getting On Board” Q&A sessions, or they may submit questions using the Policy Clarification system (https://my.ncqa.org).

Both practice-based recognition programs require an eligibility call before an application is submitted for multi-site or multi-specialty determinations. NCQA Recognition program staff work with practices to determine the survey’s structure. The eligibility call will give your practice specific expectations about documentation requirements for demonstrating how clinicians meet the elements.

Q: Is there a document that shows what standards are the same as PCMH standards for multi-sites, at the corporate level?

A: Yes. The PCSP-PCMH crosswalk, which contains this information, and the corporate elements list are both available on the “Resources” page of the application.

Q: Are the PCSP standards related to the CMS Meaningful Use standards?

A: The PCSP program seeks to align with Meaningful Use which enables practices to provide Meaningful Use reports for certain factors where applicable. The standards and guidelines identify factors that align with the current Meaningful Use requirements with plus signs (e.g., +Meaningful Use Modified Stage 2; ++CMS Meaningful Use Requirement).

Q: Is Meaningful Use required for recognition?

A: No. To the extent possible, PCSP standards align with CMS Meaningful Use requirements.

Appendix 2 of the publication is a crosswalk between PCSP standards and Meaningful Use Modified Stage 2.

Although NCQA encourages practices to pursue achievement of Meaningful Use requirements, and acknowledges the significance of this accomplishment, it is not required for PCSP recognition. Practice settings that cannot meet the Meaningful Use criteria may successfully achieve all levels of PCSP recognition.

Q: Is there a streamlined documentation process for specialty providers who are on the same EMR and in the same medical group as primary care providers who are PCMH recognized?

A: For practices with both primary care and specialty clinicians, please refer to the PCMH-PCSP auto-credit table on the NCQA Resources webpage for information on specific elements and factors on which PCSP practices may receive auto-credit from a PCMH recognition within the same practice. 

Q: Will there be an NCQA Distinction in Patient Experience Reporting component to the PCSP program, as there is with the PCMH survey?

A: No. There is currently no distinction component to the PCSP program because there is no PCSP-specific CAHPS module.

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