Are You Eligible for Oncology Medical Home Recognition?
NCQA Recognition programs are clinical practice site-based evaluations for clinicians and care organizations who provide care to patients as part of the medical neighborhood. Each program evaluates how care is provided to all patients in the practice based on the role of the entity as a medical home neighbor.
How is a Practice Defined?
Recognition is earned at the practice level. An eligible practice consists of one or more clinicians (including all eligible non-primary care clinicians) who practice together and provide oncology speciality care at a single geographic location. “Practicing together” means that all the clinicians:
- Follow the same procedures and protocols.
- Have access to (as appropriate) and share medical records (paper and electronic) for all patients treated at the practice site.
- Electronic and paper-based systems and procedures support clinical and administrative functions (e.g., scheduling, treating patients, ordering services, prescribing, maintaining medical records and follow-up).
What Types of Practices Qualify?
The Recognition program is for oncology practices that consist of:
- An incorporated group of clinicians in an office site who use the same systems and staff.
- Individual clinicians who maintain their own systems and may or may not share an office with other clinicians.
- A group of clinicians at one location that is part of a larger medical group with several locations.
- A practice within a multi-site group.
- A practice within a multi-specialty practice.
- Hospital-based specialty care practices.
How is a Multi-Site Group Defined?
A multi-site group is defined as 3 or more non-primary care practice sites using the same systems and processes, including an EMR system.
Clinicians Who Qualify for Oncology Medical Home
Clinicians qualify if they specialize in oncology and are:
- Non-primary care specialty doctors of medicine (MD), or
- Doctors of osteopathy (DO), or
- Advanced practice registered nurses (APRN) (including nurse practitioners and clinical nurse specialists).
Clinicians Who Do Not Qualify
Clinicians do not qualify if they:
- Are physicians, nurse practitioners and physician assistants who practice in the specialty of internal medicine, family medicine or pediatrics, with the intention of serving as the personal, primary care clinician for their patients.
- Do not share or have their own panel of patients.
Application Rules for Recognition for Single-Specialty Practices
In one defined specialty:
- All eligible oncology clinicians in the practice are included in the application for recognition. The practice identifies the specialty and all clinicians seeking recognition before its review.
Application Rules for Recognition for Multi-Specialty Practices
In a multi-specialty practice that includes oncology and other specialties:
- All eligible clinicians coming forward for review must practice together. The practice identifies the unit seeking recognition, the specific site and each clinician practicing at the site.
- If the unit seeking recognition includes non-oncology specialties, eligible clinicians may pursue Patient-Centered Specialty Practice (PCSP) Recognition.
In a multi-specialty practice that does not include primary care:
- All eligible clinicians practicing a defined specialty and all eligible nonprimary care clinicians are included in the application for recognition.
- All eligible clinicians practicing as part of a defined practice unit and all non-primary care clinicians are included in the application for recognition. The practice identifies the unit seeking recognition, the specific site and all clinicians in the practice.