NCQA CONVENES EXPERTS TO UPDATE NATIONAL STANDARDS FOR
PATIENT-CENTERED MEDICAL HOME RECOGNITION PROGRAM

Task Force Will Also Examine Relationship to
Evaluating “Accountable Care Organizations”

WASHINGTON – The National Committee for Quality Assurance (NCQA) today announced plans to revise its landmark evaluation of medical practices through the Physician Practice Connections®―Patient-Centered Medical Home™ (PPC®-PCMH™) to reflect the growing interest in this promising approach to improving care quality. Since its introduction in 2008, NCQA’s PPC-PCMH program has recognized more than 300 medical practices across the U.S. In recent months, the medical home model has gained greater visibility with its inclusion in several statewide programs and in health reform bills now pending in Congress.

“The medical home model has taken root across the country and with each day new ideas are emerging. We are learning from the experiences of physician practices and continuing to evolve our approach to reflect these promising developments,” said NCQA President Margaret E. O’Kane.

To help guide the update process, NCQA has named a 23-member panel of experts to the PPC-PCMH Advisory Committee chaired by Susan Edgman-Levitan, P.A., Executive Director, Stoeckle Center for Primary Care Innovation at Mass General Hospital. NCQA anticipates revised standards that continue to be feasible for individual practices and that also encourage better coordination and integration across systems.

A second task force, chaired by Robert Margolis, M.D., CEO of HealthPartners of California will explore how to apply the medical home standards and other quality requirements to accountable care organizations (ACOs) and provide guidance to the broader committee. The PPC-PCMH Advisory Committee will apply findings from research and practical application of the medical home model in demonstration projects to inform the update. Among the questions the committee will explore are how to:

  • Define aspects of the model that can improve quality and save money
  • Incorporate patient experience into the evaluation of practices
  • Incorporate clinical care results into the evaluation of practices
  • Recognize the role of non-physician clinicians
  • Align standards with federal “meaningful use” requirements for electronic health records

“The medical home is an evolving concept and I look forward to supporting the evolution of NCQA’s standards as we hear the ideas and experiences of stakeholders from across the health care system,” said Edgman-Levitan.

Public Comment Opportunities

The Advisory Committee will review suggestions and propose draft changes to PPC-PCMH standards in the first quarter of 2010. Public comments on the draft changes will be sought in the second quarter of next year. NCQA will approve final recommendations in late 2010 and publish these in January 2011.

The Advisory Committee includes: 

  • Chair: Susan Edgman-Levitan, PA, Stoeckle Center for Primary Care Innovation, Mass General Hospital
  • Melinda Abrams, M.S.  The Commonwealth Fund
  • Bruce Bagley, M.D., American Academy of Family Physicians
  • Michael Barr, M.D., M.B.A., F.A.C.P., American College of Physicians
  • Duane Davis, M.D., F.A.C.P., F.A.C.R., Geisinger Health System
  • Thomas Foels, M.D., M.M.M., Independent Health Plan of Buffalo, N.Y.
  • Foster Gesten, M.D., New York State Department of Health
  • Alan Glaseroff, M.D., Humboldt Del Norte IPA
  • Veronica Goff, National Business Group on Health
  • Paul Grundy, M.D., M.P.H., IBM Global Wellbeing Services and Health Benefits
  • Marjie Harbrecht, M.D., Colorado Community Guidelines Collaborative
  • Shawn Martin, American Osteopathic Association
  • Edward G. Murphy, M.D., Carilion Health System
  • Mary Naylor, Ph.D., FA.A.N., R.N.., University of Pennsylvania School of Nursing
  • Ann S. O’Malley, M.D., M.P.H., Center for Studying Health System Change
  • Amanda Parsons, M.D., M.B.A. New York City Department of Health & Mental Hygiene
  • Lee Partridge, National Partnership for Women and Families
  • Carol Reynolds-Freeman, M.D., Potomac Physicians
  • Marc Rivo, M.D., M.P.H., Prestige Health Choice
  • Jeff Schiff, M.D., Minnesota Department of Human Services
  • Xavier Sevilla, M.D., F.A.A.P., American Academy of Pediatrics
  • Ann S. Torregrossa, Commonwealth of Pennsylvania
  • Ed Wagner, M.D., M.P.H., Group Health Cooperative of Puget Sound

The PPC-PCMH is the leading evaluation tool for practices seeking to participate in demonstration programs. It has been endorsed for use in such programs by the American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics, American Osteopathic Association, American Medical Association, National Quality Forum and other medical organizations, and has been adopted by Medicare for use in a Congressionally-mandated demonstration project. To date, more than 500 practices involving more than 4,600 physicians have gone through NCQA review and been recognized as meeting the requirements for a medical home under PPC-PCMH and its predecessor program.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA accredits and certifies a wide range of health care organizations and recognizes physicians in key clinical areas. More than 7 in 10 Americans enrolled in health plans are in an NCQA-Accredited plan. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices.

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