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School-Based Medical Home Recognition Program

There are more than 2,300 school-based health centers (SBHC) in 49 states that provide comprehensive medical care to children and adolescents largely in communities with high percentages of low-income families. These centers provide medical, mental health, and often dental and vision care, to students in a clinic located in the school building.

NCQA School-Based Medical Home (SBMH) Recognition for SBHCs is built on the patient-centered medical home (PCMH) model, which puts patients first. It emphasizes team-based care, effective communication and coordination and helps foster relationships between patients and their clinical care teams.

What is NCQA Recognition? 

NCQA Recognition programs are developed from evidence-based concepts, competencies and criteria. These programs distinguish clinicians, practices and care entities that follow medical evidence to deliver quality care and improve over time. Payers, medical specialty boards and others use NCQA Recognition to identify providers that excel in providing high-quality, patient-centered care.

 

SBHCs download the standards and guidelines document, review the criteria, perform a gap analysis and apply the criteria based on their needs. After transformation, they use NCQA’s Q-PASS system to submit evidence to NCQA that they meet standard requirements. Centers that do, earn recognition status and can display the NCQA seal.


What’s in the School-Based Medical Home Program? 

The SBMH Recognition program is a hybrid model program that evaluates how school-based health centers perform as a medical home, provide episodic care for students with urgent or emergent needs and act as a collaborative care center for students and the community served. School-based health centers seeking recognition demonstrate they meet NCQA PCMH requirements and complete the school-based health center subset of requirements in the same evaluation.

This program offers recognition to SBHCs performing a range of services for patients, whether as a primary care medical home, a coordinated care provider in support of an outside primary care provider or an episodic care provider that addresses issues during the school day.

To be eligible to apply for SBMH Recognition, a school-based health center must operate as a full medical home for less than 75 percent of the population and provide coordinated services with a patient’s primary care provider or provide episodic care for students with urgent or emergent needs.

SBMH Requirements 

Transforming into an SBMH starts with understanding the concepts, competencies and criteria that make up the program. NCQA evaluates organizations based on these areas – found in the Standards & Guidelines Document

SBMH Program Concepts 


  Team-Based Care and Practice Organization 
Helps structure a practice’s leadership and care team responsibilities, how the practice partners with patients, families and caregivers.  
  Knowing and Managing Your Patients
Sets standards for data collection, medication reconciliation, evidence-based clinical decision support and other activities.

  Patient-Centered Access and Continuity 
Guides practices to give patients convenient access to clinical advice, helps ensure continuity of care. 

  Care Management and Support 
Helps clinicians set up care management protocols to identify patients who need more closely managed care. 

  Care Coordination and Care Transitions 
Ensures that primary and specialty care clinicians share information effectively and manage patient referrals to minimize cost, confusion and inappropriate care. 

  Performance Measurement and Quality Improvement
Helps practices develop ways to measure performance, set goals and develop activities that will improve performance.
  School-Based Health Center
Focuses on services provided by SBHCs to nonmedical home patients, with the goal of ensuring that care is coordinated and addresses episodic care needs.

 

NCQA SBMH Recognition: Getting Started

Ready to earn recognition, but not sure where to start? Learn more about available resources and the process for NCQA SBMH Recognition. 

Standards & Guidelines. Transformation to an SBMH starts with understanding the concepts, competencies and criteria that make up the program. Start by downloading a free copy of the SBMH Standards & Guidelines from the NCQA store

Pricing. Learn more about pricing and payment options. 

Enroll Through Q-PASS. When you are familiar with the standards and have started to transform your center, create an account, enroll in the recognition process at qpass.ncqa.org, complete an initial questionnaire and pay the enrollment fee. Learn more about what will be required at enrollment.