PCMH Redesign Update: Making Progress But A Lot More To Do

June 15, 2015 · Michael S. Barr, MD

Earlier this spring we asked for your perspective. You delivered. We were extremely pleased with the response to our Ideas4PCMH post in March. And it’s those perspectives—of patients, practitioners, consultants, health plan decision makers, and others —that are fueling the expedited evolution of NCQA’s Patient-Centered Medical Home (PCMH) Recognition Program.

The vast majority of comments support the changes being considered. Others offer detailed suggestions or challenged us to think differently. Even the critical comments will help us understand how the program is perceived.  Some responses included recommendations for changing the PCMH 2014 standards. We appreciate those suggestions and will consider them when the review process for the PCMH 2017 update starts in 2016.

To complement the feedback received by email, NCQA conducted 17 focus groups with a variety of stakeholders including small/large practices, professional societies, health plans, hospitals, accountable care organizations, community health centers, health IT companies, PCMH Certified Content Experts (CCEs), and representatives of State-based agencies. We also talk to people during our educational conferences, and of course, monitor published commentaries about the recognition process.

As outlined previously, the PCMH redesign strategy includes four major components:

  1. Provide more guidance to practices through new channels, including live support, online resources and improved customer service;
  2. Introduce a streamlined annual check-in for recognized practices rather than requiring a full documentation review every three years;
  3. Use information generated in the course of daily clinical care to support the recognition process; and,
  4. Redesign our online survey tool to be more user-friendly and efficient.

In July, NCQA will conduct a 3-6 month pilot of the new processes under consideration with practices going through recognition for the first time as well as practices scheduled to renew their recognition. We will learn. We will adjust. We will use these experiences to refine the PCMH design. Then, we’ll once again solicit additional feedback through the Ideas4PCMH forum. Lessons learned will influence the development of the fourth generation of NCQA PCMH standards and guidelines, which we will release in 2017.

As noted earlier, our improvement effort includes collecting information generated in the course of providing care, NCQA is collaborating with a few health IT vendors to test the ability to receive data about quality measures. To date, we’ve received test data submissions from three health IT vendors representing ~500 practices (3600+ clinicians) on about 100 quality measures. While there is considerable work to be done to verify the accuracy and reliability of these data, we are encouraged by the early results. NCQA is also moving forward with our health IT pre-validation program. 21 health IT vendors have gone through the pre-validation program thus far and approximately 50 more have inquired about the requirements. During the past five months, 400 practice sites have submitted data for their PCMH recognition through 15 different pre-validated health IT products.

We are also pleased to announce that NCQA has engaged a digital agency with unique expertise in user experience to help design our new online submission platform. During the next three to five months, our contractor will talk to focus groups, participate in our internal discussions, and review submitted comments. At the end of this first phase of development, the agency will present a design concept for the online platform to support the updated PCMH recognition process. Our goal is to approve the final design concept late this year with the intent to build and test it during 2016.

We are excited about the planned changes and we’ve developed quite a to-do list. Our team is pushing hard to deliver on your expectations for a more engaging and productive recognition program. That’s because we all have the same goal—improving the care people receive, their experiences with health care, and the need to reduce costs. We also understand a positive experience for those delivering care is essential.

We’ll keep you posted and solicit your opinions on specific design features along the way but always welcome your thoughts and suggestions at ideas4pcmh@ncqa.org.

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