New NCQA Standards Take Patient-Centered Medical Homes To The Next Level


PCMH 2011 Updates America’s Most Widely Used Model of Care the Way “Patients Want It to Be”

WASHINGTON, D.C. — On January 31, the National Committee for Quality Assurance (NCQA) will release new standards for its Patient-Centered Medical Home (PCMH) program. The new standards call on medical practices to be more patient-centered, and reinforce federal “meaningful use” incentives for primary care practices to adopt health information technology.

The patient-centered medical home is a model of care emphasizing care coordination and communication to transform primary care into “what patients want it to be.” Research shows that medical homes can lead to higher quality and lower costs, and improve patients’ and providers’ reported experiences of care.

The release of NCQA’s new standards—PCMH 2011—marks the debut of the next generation of the NCQA Recognition program that designates high-quality primary care practices as patient-centered medical homes.

Expansion of this program—a 3,400% increase in recognized clinicians and a 5,200% increase in recognized sites since 2008—makes it NCQA’s fastest-growing service. As of the end of 2010, almost 7,700 clinicians at more than 1,500 sites across America used NCQA standards as a roadmap to become high-quality primary care practices and receive NCQA Recognition as patient-centered medical homes.

“PCMH 2011 advances the patient-centered medical home as a paragon of 21st-century primary care,” said NCQA President Margaret E. O’Kane. “By emphasizing access, health information technology and partnerships between clinicians and patients to improve health, these new standards raise the bar in defining high-quality care.”

“NCQA’s new medical home standards will enhance care coordination, clinician and staff satisfaction and primary care quality nationwide, while putting patients in the driver’s seat to manage their health,” explained Susan Edgman-Levitan, leader of the 22-member advisory committee that helped NCQA create PCMH 2011 and Executive Director of the Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital. 

WHAT’S NEW IN PCMH 2011 

More emphasis on being patient-centered, using patient feedback

To an unprecedented degree, PCMH 2011 directs practices to organize care according to patients’ preferences and needs. Standards emphasize access to care during and after office hours, and managing care in collaboration with patients and families. Other aspects of patient-centeredness include providing services in patients’ preferred languages, helping patients with self-care and facilitating patient access to community resources.

PCMH 2011’s emphasis on patient feedback supports what is widely known as the “triple aim” (improving quality, containing costs and enhancing patient experience). NCQA is collaborating with the Agency for Healthcare Research and Quality to develop a medical home version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group Survey, a widely used evaluation of patient experience. NCQA expects to release CAHPS for medical homes in the second half of 2011. Starting in January 2012, practices may receive additional NCQA Distinction by voluntarily reporting patient experience data.

To support patient-centered care for children, PCMH 2011 standards include parental decision making, teen privacy and guardianship. Standards also cover communication between medical facilities about newborns’ lab results and guidelines for planning the transition from pediatric to adult care.

Support for health information technology

Federal “meaningful use” language is embedded in PCMH 2011 evaluation standards, reinforcing incentives for practices to use health information technology to improve quality.

The standards’ alignment with meaningful use creates a virtuous cycle: practices that meet PCMH 2011 requirements will be well prepared to qualify for meaningful use, and vice versa.

GET THE STANDARDS

Download PCMH 2011 standards free of charge at www.ncqa.org/view-pcmh2011.

ABOUT NCQA

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

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